Provider Demographics
NPI:1730406604
Name:EDWARDS, NEAL C (DDS)
Entity type:Individual
Prefix:DR
First Name:NEAL
Middle Name:C
Last Name:EDWARDS
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 1:3731 TIBBETTS ST STE 7
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-2604
Mailing Address - Country:US
Mailing Address - Phone:951-614-0033
Mailing Address - Fax:
Practice Address - Street 1:3731 TIBBETTS ST STE 7
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2604
Practice Address - Country:US
Practice Address - Phone:951-614-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA560381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice