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NPI Code Detail

MEDICARE: DR. EUNJUNG EDWARDS DDS

MEDICARE: DR. EUNJUNG EDWARDS 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
1122300000XDentist9009TN
2122300000XDentist25093TX
3122300000XDentist3749AR

General Provider Information

NPI Number : 1720216880
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EUNJUNG EDWARDS DDS
Provider Business Mailing Address
First Line : 845 S HIGHLAND ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38111-4254
Country : US
Telephone Number : 901-323-8488
Fax Number : 901-323-8489
Provider Business Practice Location Address
First Line : 845 S HIGHLAND ST
Second Line :
City : MEMPHIS
State : TN
Zip : 38111-4254
Country : US
Telephone Number : 901-323-8488
Fax Number : 901-323-8489
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2009
Last Update Date : 03/15/2011

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