Provider Demographics
NPI:1437215985
Name:EDWARDS, TIMOTHY LEE (DDS)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:LEE
Last Name:EDWARDS
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 1:6600 PERIMETER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-8033
Mailing Address - Country:US
Mailing Address - Phone:614-761-7666
Mailing Address - Fax:614-761-8653
Practice Address - Street 1:6600 PERIMETER DR STE 100
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-8033
Practice Address - Country:US
Practice Address - Phone:614-761-7666
Practice Address - Fax:614-761-8653
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH202811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice