Provider Demographics
NPI:1114247350
Name:EDWARDS, COURTNEY P (DDS)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:P
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7938 WOLF RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1725
Mailing Address - Country:US
Mailing Address - Phone:901-754-3117
Mailing Address - Fax:
Practice Address - Street 1:7938 WOLF RIVER BLVD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1725
Practice Address - Country:US
Practice Address - Phone:901-754-3117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS4026-18122300000X
NC8943122300000X
TN10413122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist