Provider Demographics
NPI:1508870684
Name:STEWART, EDGAR ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:ALAN
Last Name:STEWART
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 1:440 N PAIUTE DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-6181
Mailing Address - Country:US
Mailing Address - Phone:435-867-2650
Mailing Address - Fax:435-867-2658
Practice Address - Street 1:440 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:UT
Practice Address - Zip Code:84701-2855
Practice Address - Country:US
Practice Address - Phone:435-893-6806
Practice Address - Fax:435-201-5720
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6701223G0001X
UT143758-9926122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1015286Medicaid