Individual
EDWARD TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 E GLEBE RD, ALEXANDRIA, VA 22305-2938
(703) 535-5568
(703) 535-1583
Mailing address
1769 LEXINGTON AVE N # 104, ROSEVILLE, MN 55113-6522
(703) 535-1583
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
0402206182
VA
125J00000X
Dental Therapist
Primary
D180
MN
125K00000X
Advanced Practice Dental Therapist
D180
MN
Other
Enumeration date
01/14/2014
Last updated
06/17/2025
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