Individual
JONATHON EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1327 S NIELSON ST, GILBERT, AZ 85296-4265
(480) 868-1864
Mailing address
1327 S NIELSON ST, GILBERT, AZ 85296-4265
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D009375
AZ
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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