Individual
DOUGLAS EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5756 HIGHWAY 153, HIXSON, TN 37343-6703
(423) 875-9374
Mailing address
5756 HIGHWAY 153, HIXSON, TN 37343-6703
(423) 875-9374
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7617
TN
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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