Provider Demographics
NPI:1265616031
Name:COLE, EDWARD R (DDS)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:R
Last Name:COLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5225 E KNIGHT DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2156
Mailing Address - Country:US
Mailing Address - Phone:520-322-9300
Mailing Address - Fax:520-322-6889
Practice Address - Street 1:5225 E KNIGHT DR
Practice Address - Street 2:SUITE 401
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2156
Practice Address - Country:US
Practice Address - Phone:520-322-9300
Practice Address - Fax:520-322-6889
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ25911223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics