Provider Demographics
NPI:1144668872
Name:EARLY, JOHN BREEDEN JR (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BREEDEN
Last Name:EARLY
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 2ND LOOP RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6121
Mailing Address - Country:US
Mailing Address - Phone:843-662-1761
Mailing Address - Fax:
Practice Address - Street 1:1840 2ND LOOP RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6121
Practice Address - Country:US
Practice Address - Phone:843-662-1761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8216122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist