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NPI Code Detail

MEDICARE: ANDREA MARIE DEAN DDS

MEDICARE: ANDREA MARIE DEAN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist12012707AIN

General Provider Information

NPI Number : 1033647011
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA MARIE DEAN DDS
Provider Business Mailing Address
First Line : 430 INDIANA AVE APT 140
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-3275
Country : US
Telephone Number : 317-910-2971
Fax Number :
Provider Business Practice Location Address
First Line : 1481 W 10TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-2803
Country : US
Telephone Number : 317-554-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2017
Last Update Date : 06/02/2017

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Directions to “ ANDREA MARIE DEAN DDS” Practice Location

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