Individual
NICHOLAS HENRY EDWARDS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
507 HWY 57, GRAND JUNCTION, TN 38039-0070
(731) 764-6428
Mailing address
PO BOX 70, GRAND JUNCTION, TN 38039
(731) 764-6428
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS4045
TN
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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