Provider Demographics
NPI:1992703300
Name:CIAS, EDWARD JR (DDS)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:CIAS
Suffix:JR
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 1:58 E WELLSBORO ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16933-1134
Mailing Address - Country:US
Mailing Address - Phone:570-662-7779
Mailing Address - Fax:
Practice Address - Street 1:58 E WELLSBORO ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:PA
Practice Address - Zip Code:16933-1134
Practice Address - Country:US
Practice Address - Phone:570-662-7779
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-018209-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice