Provider Demographics
NPI:1306995055
Name:BYERS, EDWARD M (DDS)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:M
Last Name:BYERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:TED
Other - Middle Name:M
Other - Last Name:BYERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:120 NORTHVIEW RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5581
Mailing Address - Country:US
Mailing Address - Phone:928-282-5964
Mailing Address - Fax:
Practice Address - Street 1:120 NORTHVIEW RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5581
Practice Address - Country:US
Practice Address - Phone:928-282-5964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ43041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice