Provider Demographics
NPI:1164445599
Name:EDWARDS, KAREN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:A
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:PO BOX 6689
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-0689
Mailing Address - Country:US
Mailing Address - Phone:415-491-1610
Mailing Address - Fax:
Practice Address - Street 1:735 E OHIO AVE
Practice Address - Street 2:STE. #202
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3437
Practice Address - Country:US
Practice Address - Phone:760-745-5354
Practice Address - Fax:760-745-0567
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA451201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice