Individual
BRUCE D EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2115 M-119, PETOSKEY, MI 49770
(231) 347-2518
(231) 347-8530
Mailing address
2115 M-119, PETOSKEY, MI 49770
(231) 347-2518
(231) 347-8530
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2901020869
MI
1223P0300X
Periodontics
Primary
2901020869
MI
Other
Enumeration date
03/08/2013
Last updated
12/15/2017
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