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Individual

DR. TRAVIS L EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
4106 WAKE FOREST RD STE 201, RALEIGH, NC 27609-6397
(919) 277-0577
(919) 390-0019
Mailing address
351 W IOWA AVE, NAMPA, ID 83686-2856
(208) 461-2600

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
D-4211
ID
1223G0001X
General Practice Dentistry
12792
NC
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12792
NC

Other

Enumeration date
06/24/2009
Last updated
06/29/2022
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