Provider Demographics
NPI:1003336405
Name:EDGAR, JOEL CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:CHRISTOPHER
Last Name:EDGAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 LOUETTA RD STE A
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7450
Mailing Address - Country:US
Mailing Address - Phone:281-376-1214
Mailing Address - Fax:
Practice Address - Street 1:7000 LOUETTA RD STE A
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7450
Practice Address - Country:US
Practice Address - Phone:281-376-1214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX329981223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice