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NPI 1770672826

NPI 1770672826 : BENJAMIN CAL EDMUNDS DDS : FRISCO, TX

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General NPI Number Information
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    NPI Number           |    1770672826
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    Entity Type          |    Individual 
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    Provider Name        |    BENJAMIN CAL EDMUNDS DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/12/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2500 LEGACY DRIVE SUITE 210
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    City                 |    FRISCO
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    State                |    TX
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    Zip                  |    75034
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    Country              |    US
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    Telephone            |    214-618-4180
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    Fax                  |    214-618-4182
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Provider Business Mailing Address
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    Address Line         |    2500 LEGACY DRIVE SUITE 210
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    City                 |    FRISCO
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    State                |    TX
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    Zip                  |    75034
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    Country              |    US
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    Telephone            |    214-618-4180
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    Fax                  |    214-618-4182
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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        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    21106
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    License Number State |    TX
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