Provider Demographics
NPI:1033918917
Name:DENTAL ASSOCIATES OF EASLEY, PA
Entity type:Organization
Organization Name:DENTAL ASSOCIATES OF EASLEY, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:CONLEY
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:864-859-0111
Mailing Address - Street 1:254 S IRBY ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4412
Mailing Address - Country:US
Mailing Address - Phone:843-667-8880
Mailing Address - Fax:
Practice Address - Street 1:254 S IRBY ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4412
Practice Address - Country:US
Practice Address - Phone:843-667-8880
Practice Address - Fax:843-667-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty