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Individual

DR. STAN EDWIN EDWARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
1585 SW MARLOW AVE STE 220, PORTLAND, OR 97225-5178
(503) 297-7231
(503) 291-1335
Mailing address
1585 SW MARLOW AVE STE 220, PORTLAND, OR 97225-5178
(503) 297-7231
(503) 291-1335

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8733
OR
1223G0001X
General Practice Dentistry
DD2753
NM
1223G0001X
General Practice Dentistry
DE00009370
WA

Other

Enumeration date
08/24/2005
Last updated
10/29/2007
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