Individual
JESSICA LILLIAN EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3223 N BROAD ST, PHILADELPHIA, PA 19140-5007
(215) 707-2900
Mailing address
201 S 25TH ST APT 610, PHILADELPHIA, PA 19103-6008
(507) 250-6284
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
09732
IA
1223G0001X
General Practice Dentistry
Primary
DS044043
PA
Other
Enumeration date
04/02/2019
Last updated
07/18/2023
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