Individual
DR. EDWARD JORDAN TARVER IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1111 PARKWAY FRONTAGE RD N, LAKELAND, FL 33803
(863) 644-2408
Mailing address
1111 PARKWAY FRONTAGE RD N, LAKELAND, FL 33803
(863) 644-2408
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN17195
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN17195
LICENSE NUMBER
FL
Enumeration date
06/18/2006
Last updated
03/07/2023
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