Individual
DR. C.W. URIAH EDMONDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
73666 JOSHUA DR, TWENTYNINE PALMS, CA 92277-2572
(301) 742-4079
Mailing address
360 SIMONTON CREST DR, LAWRENCEVILLE, GA 30045-3509
(301) 742-4079
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
111304
CA
1223G0001X
General Practice Dentistry
13821
MD
1223G0001X
General Practice Dentistry
4237
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
039320700
—
MD
05
—
3810021389
—
WV
Enumeration date
02/02/2006
Last updated
04/30/2025
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