Individual
DR. EDWARD JACOB CLEMONS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5011 SOUTHPARK DR, SUITE 110, DURHAM, NC 27713-7738
(919) 361-9700
(919) 361-9747
Mailing address
5011 SOUTHPARK DR, SUITE 110, DURHAM, NC 27713-7738
(919) 361-9700
(919) 361-9747
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5581
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8991662
—
NC
01
—
91662
BCBS
NC
Enumeration date
06/28/2006
Last updated
01/15/2008
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