Individual
DEBRA S EDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1000 VALE TERRACE DR, VISTA, CA 92084-5218
(760) 631-5000
(760) 414-3710
Mailing address
1000 VALE TERRACE DR, VISTA, CA 92084-5218
(760) 631-5000
(760) 414-3710
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019027560
IL
122300000X
Dentist
Primary
56859
CA
1223G0001X
General Practice Dentistry
20568
MA
Other
Enumeration date
08/16/2005
Last updated
03/09/2016
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