Provider Demographics
NPI:1487908976
Name:CHRIS E. EDMONDSONDDS & ASSOCIATES, PLLC
Entity type:Organization
Organization Name:CHRIS E. EDMONDSONDDS & ASSOCIATES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ELLIOT
Authorized Official - Last Name:EDMONDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:940-591-9700
Mailing Address - Street 1:2219 S LOOP 288 STE 215
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4983
Mailing Address - Country:US
Mailing Address - Phone:940-591-9700
Mailing Address - Fax:940-387-7982
Practice Address - Street 1:2219 S LOOP 288 STE 215
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4983
Practice Address - Country:US
Practice Address - Phone:940-591-9700
Practice Address - Fax:940-387-7982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX190321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty