Individual
DR. TERYL DALE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
220 W RIDGEWAY, SUITE 201, WATERLOO, IA 50701
(319) 232-9023
(319) 232-1610
Mailing address
228 BERKSHIRE RD, WATERLOO, IA 50701
(319) 232-4505
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6453
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101
JOHN DEERE
IA
05
—
0163089
—
IA
01
—
10519
BCBS OF AL
AL
01
—
16549
BCBS
—
01
—
311848
311848
KS
01
—
506900
UCCI
—
Enumeration date
08/22/2006
Last updated
07/08/2007
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