Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 0401417047 | VA |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 0401417047 | VA |
N | 204E00000X | Oral & Maxillofacial Surgeon | R9427 | TX |
NPI | 1295091064 |
---|---|
Provider Name | Dr. Edward Weston Santee |
First Address | Norfolk, VA 23510-1066 |
Second Address | Norfolk, VA 23510-1066 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2012 |
Last Update Date | 04/06/2021 |