Provider Demographics
NPI:1033649249
Name:BAUST, EDWARD MCARTHUR III (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:MCARTHUR
Last Name:BAUST
Suffix:III
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 1:2905 BRIARCLIFFE RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27106-3076
Mailing Address - Country:US
Mailing Address - Phone:252-756-3313
Mailing Address - Fax:
Practice Address - Street 1:2905 BRIARCLIFFE RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-3076
Practice Address - Country:US
Practice Address - Phone:404-729-9508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC107241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice