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General NPI Number Information
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NPI Number | 1699987610
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Entity Type | Individual
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Provider Name | MICHELLE ANN EDWARDS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1192 SUNCAST LN SUITE 3
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-9330
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Country | US
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Telephone | 916-939-9912
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Fax | 916-939-9231
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Provider Business Mailing Address
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Address Line | 349 GLEN RIDGE CT
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-4447
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Country | US
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Telephone | 916-939-8882
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 50068
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License Number State | CA
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