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General NPI Number Information
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NPI Number | 1376893271
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Entity Type | Organization
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Legal Business Name | MICHAEL D. EDWARDS, D.M.D.,P.C.
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 449 MAIN STREET NORTH
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City | WEDOWEE
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State | AL
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Zip | 36278-0370
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Country | US
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Telephone | 256-357-2882
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Fax | 256-257-2883
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Provider Business Mailing Address
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Address Line | PO BOX 370
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City | WEDOWEE
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State | AL
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Zip | 36278-0370
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Country | US
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Telephone | 256-357-2882
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Fax | 256-357-2883
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL D. EDWARDS
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Credential |
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Telephone | 256-357-2882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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