Provider Demographics
NPI:1699455196
Name:EDWARDS AND GONZLEZ DDS PLLC
Entity type:Organization
Organization Name:EDWARDS AND GONZLEZ DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:TRIMBLE
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:143-277-0178
Mailing Address - Street 1:8131 DORADO DR
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-8533
Mailing Address - Country:US
Mailing Address - Phone:432-770-1786
Mailing Address - Fax:800-532-0728
Practice Address - Street 1:8131 DORADO DR
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765-8533
Practice Address - Country:US
Practice Address - Phone:432-770-1786
Practice Address - Fax:800-532-0728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty