NPI | 1013966019 |
---|---|
Other Name | CHUCK EDWARDS |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: CA 51732) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: TX 0014494) |
Enumeration Date | 2006-05-08 |
Last Update Date | 2011-01-28 |