Provider Demographics
NPI:1194093658
Name:EDWARDS, PAMELA O (DMD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:O
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3849
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36547-3849
Mailing Address - Country:US
Mailing Address - Phone:251-500-1025
Mailing Address - Fax:251-500-1013
Practice Address - Street 1:116 COVE AVE
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542
Practice Address - Country:US
Practice Address - Phone:251-500-1025
Practice Address - Fax:251-500-1013
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL42271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice