Individual
DR. JUSTIN S EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
2113 HARTFORD RD, HAMPTON, VA 23666-2575
(757) 838-0800
Mailing address
4550 ROCK WREN DRIVE, PROVIDENCE FORGE, VA 23140
(509) 434-9364
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0442000107
VA
1223P0221X
Pediatric Dentistry
Primary
0401413260
VA
Other
Enumeration date
07/30/2009
Last updated
05/20/2013
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