Provider Demographics
NPI:1134203482
Name:GARRISON, EDWIN BUD (DDS)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:BUD
Last Name:GARRISON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4188 E US 64
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906
Mailing Address - Country:US
Mailing Address - Phone:828-837-2113
Mailing Address - Fax:828-837-2113
Practice Address - Street 1:4188 E US 64
Practice Address - Street 2:SUITE 10
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906
Practice Address - Country:US
Practice Address - Phone:828-837-2113
Practice Address - Fax:828-837-2113
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3444122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC93094OtherNC BLUE CROSS BLUE SHIELD