Provider Demographics
NPI:1396055760
Name:EDWARDS, FLORENCE (DDS)
Entity type:Individual
Prefix:DR
First Name:FLORENCE
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04102-1713
Mailing Address - Country:US
Mailing Address - Phone:207-272-7637
Mailing Address - Fax:
Practice Address - Street 1:11 LITTLE RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-1713
Practice Address - Country:US
Practice Address - Phone:207-272-7637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038510122300000X
MEDEN4275122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist