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General NPI Number Information
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NPI Number | 1326242512
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Entity Type | Individual
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Provider Name | EDWARD CHARLES SHARP D.D.S., M.S.
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Gender | Male
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 07/07/2014
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Provider Practice Location Address
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Address Line | 46900 MONROE ST
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City | INDIO
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State | CA
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Zip | 92201-4827
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Country | US
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Telephone | 760-396-5733
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Fax |
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Provider Business Mailing Address
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Address Line | 80533 CAMINO SANTA JULIANA
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City | INDIO
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State | CA
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Zip | 92203-7502
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Country | US
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Telephone | 760-297-2110
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 18408
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License Number State | CA
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