Individual
DR. MARK ALLEN EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1161 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34952-5332
(772) 335-7766
(772) 335-1951
Mailing address
1161 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34952-5332
(772) 335-7766
(772) 335-1951
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10361
FL
Other
Enumeration date
09/07/2006
Last updated
07/08/2007
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