Individual
DR. EDWARD LESLIE WIDRONAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
619 LOWELL ST, PEABODY, MA 01960
(978) 535-3443
Mailing address
619 LOWELL ST, PEABODY, MA 01960
(978) 535-3443
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10931
MA
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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