Healthcare Provider Details

I. General information

NPI: 1215821376
Provider Name (Legal Business Name): BRYAN WARD ANDREW DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 LONG SHOALS RD
ARDEN NC
28704-7783
US

IV. Provider business mailing address

31 LONG SHOALS RD
ARDEN NC
28704-7783
US

V. Phone/Fax

Practice location:
  • Phone: 828-348-7006
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14851
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: