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NPI Code Detail

MEDICARE: DR. EDGAR DAVID PRINDLE DDS

MEDICARE:  DR. EDGAR DAVID PRINDLE  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry032227NY

General Provider Information

NPI Number : 1578687430
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDGAR DAVID PRINDLE DDS
Provider Business Mailing Address
First Line : 774 PRE EMPTION RD
Second Line :
City : GENEVA
State : NY
Zip : 14456-1336
Country : US
Telephone Number : 315-789-8975
Fax Number :
Provider Business Practice Location Address
First Line : 774 PRE EMPTION RD
Second Line :
City : GENEVA
State : NY
Zip : 14456-1336
Country : US
Telephone Number : 315-789-8975
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2007
Last Update Date : 07/08/2007

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Directions to “ DR. EDGAR DAVID PRINDLE DDS” Practice Location

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