Individual
DR. ATOM JACOB EDENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
109 W BEARSS AVE, TAMPA, FL 33613-1219
(813) 632-3118
(813) 969-3096
Mailing address
109 W BEARSS AVE, TAMPA, FL 33613-1219
(813) 632-3118
(813) 969-3096
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN19626
FL
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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