Individual
EDWARD TERRY
Active
Individual
EDWARD TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
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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