Individual
DR. JOHN WESLEY EDMUNDS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
201 CHURCH ST, CLOVER, SC 29710-1008
(803) 222-7711
Mailing address
1253 LAWRENCE RD, CLOVER, SC 29710-7713
(704) 914-6538
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9891
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9891
SC BOARD OF DENTISTRY DENTAL LICENSE NUMBER
SC
Enumeration date
05/28/2021
Last updated
05/28/2021
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