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Individual

DR. CORY BLAKE EDWARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D., M.S.

Contact information

Practice address
1063 NARROWS WAY, SUITE B, BIRMINGHAM, AL 35242
(205) 981-9100
(205) 995-3762
Mailing address
1063 NARROWS WAY, SUITE B, BIRMINGHAM, AL 35242
(205) 981-9100
(205) 995-3762

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5217
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
515 37373
BLUECROSS BLUESHIELD
AL
Enumeration date
04/12/2007
Last updated
07/08/2007
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