Provider Demographics
NPI:1013973908
Name:CLONINGER, JOHN LESTER (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LESTER
Last Name:CLONINGER
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 1:640 S MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-3736
Mailing Address - Country:US
Mailing Address - Phone:704-732-3336
Mailing Address - Fax:704-735-3637
Practice Address - Street 1:640 S MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3736
Practice Address - Country:US
Practice Address - Phone:704-732-3336
Practice Address - Fax:704-735-3637
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice