# DR. SUSAN P EDDLEMAN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518298231
- **Authorized official:** DR. SUSAN EDDLEMAN DDS (DENTIST)
- **Authorized official phone:** (660) 744-5391

## Contact information

- **Practice address:** 204 S MAIN ST, ROCK PORT, MO 64482-1532
- **Practice address phone:** (660) 744-5391
- **Practice address fax:** (660) 744-5301
- **Mailing address:** 204 S MAIN ST, PO BOX 282, ROCK PORT, MO 64482-1532
- **Mailing address phone:** (660) 744-5391
- **Mailing address fax:** (660) 744-5301

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 14169 | MO | Yes |

## Other

- **Enumeration date:** 01/20/2010
- **Last updated:** 01/20/2010