Individual
MR. MICHAEL W EDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
85 CUDE LN, MADISON, TN 37115-2292
(615) 859-2262
(615) 859-1532
Mailing address
PO BOX 305172, DEPT 56, NASHVILLE, TN 37230-5172
(615) 425-2708
(615) 370-0778
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS02226
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007475
BLUE CROSS BLUE SHIELD
TN
Enumeration date
09/07/2006
Last updated
07/08/2007
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