Provider Demographics
NPI:1295746261
Name:EDMONDS, ROBERT M (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:EDMONDS
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 1:2995 CHURCHLAND BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5642
Mailing Address - Country:US
Mailing Address - Phone:757-484-4832
Mailing Address - Fax:757-483-9320
Practice Address - Street 1:2995 CHURCHLAND BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5642
Practice Address - Country:US
Practice Address - Phone:757-484-4832
Practice Address - Fax:757-483-9320
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA80121223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics