Individual
JASMINE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
204 N WESTOVER BLVD, ALBANY, GA 31707-2983
(229) 888-6559
Mailing address
204 N WESTOVER BLVD, ALBANY, GA 31707-2983
(229) 888-6559
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN015177
GA
1223G0001X
General Practice Dentistry
Primary
DN015177
GA
Other
Enumeration date
05/17/2016
Last updated
06/10/2016
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