# DEBRA S EDSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1770575888
- **Gender:** F
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 019027560 | IL | — |
| 122300000X | Dentist | 56859 | CA | Yes |
| 1223G0001X | General Practice Dentistry | 20568 | MA | — |

## Other

- **Enumeration date:** 08/16/2005
- **Last updated:** 03/09/2016