Provider Demographics
NPI:1679597603
Name:EDWARDS, DEBORAH LOUISE (DMD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LOUISE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 SEXTON RD
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-5704
Mailing Address - Country:US
Mailing Address - Phone:724-349-2322
Mailing Address - Fax:
Practice Address - Street 1:27 S 9TH ST
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-2602
Practice Address - Country:US
Practice Address - Phone:724-465-6921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS212741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice