Most Relevant Information
Provider Data
| NPI Number: | 1003220039 |
| Provider Name: | JEREMY ALAN EDWARDS DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/18/2014 |
| Last Updated: | 06/17/2022 |
Provider Practice Location
1004 MEDICAL PARK BLVD
EDMOND
OK
730133025
Practice Location Phone/Fax
| Phone: | 4053488184 |
| Fax: | 4053485349 |
Provider Mailing Location
1004 MEDICAL PARK BLVD
EDMOND
OK
730133025
Provider Mailing Phone/Fax
| Phone: | 4053488184 |
| Fax: | 4053485349 |