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General NPI Number Information
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NPI Number | 1598781536
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Entity Type | Individual
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Provider Name | GREGORY EDWARDS DDS
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 1811 S RAINBOW BLVD STE 208
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City | LAS VEGAS
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State | NV
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Zip | 89146-0894
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Country | US
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Telephone | 702-433-2489
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Fax | 702-434-2483
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Provider Business Mailing Address
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Address Line | 4125 ERINBIRD AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89084-4807
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Country | US
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Telephone | 702-396-5746
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Fax | 702-307-1903
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2741
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License Number State | NV
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