Individual
DR. GWENDOLYN ANN EDMONDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
6221 COVINGTON RD, FORT WAYNE, IN 46804-7311
(260) 432-4329
(260) 434-1570
Mailing address
6221 COVINGTON RD, FORT WAYNE, IN 46804-7311
(260) 432-4329
(260) 434-1570
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12008899
IN
Other
Enumeration date
10/06/2006
Last updated
07/08/2007
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