Individual
DR. THADDEUS CARL EDWARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2727 SAINT MARYS AVE, HANNIBAL, MO 63401-3774
(573) 221-1227
Mailing address
2727 SAINT MARYS AVE, HANNIBAL, MO 63401-3774
(573) 221-1227
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2018018253
MO
Other
Enumeration date
06/04/2018
Last updated
06/04/2018
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