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Individual
DR. EDWARD D. DALLAM
Active
Individual
DR. EDWARD D. DALLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12689
KS
332B00000X
Durable Medical Equipment & Medical Supplies
12689
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06778074
BLUE CROSS BLUE SHEILD KC
MO
Enumeration date
03/07/2007
Last updated
02/20/2019
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