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General NPI Number Information
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NPI Number | 1295739126
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Entity Type | Individual
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Provider Name | ANDREW N DENTINO MD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 5423 S MCCOLL RD
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City | EDINBURG
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State | TX
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Zip | 78539-9183
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Country | US
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Telephone | 956-362-3575
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Fax | 956-362-3584
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Provider Business Mailing Address
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Address Line | 5423 S MCCOLL RD
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City | EDINBURG
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State | TX
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Zip | 78539-9183
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Country | US
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Telephone | 956-362-3575
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Fax | 956-362-3584
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 29405
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 19565
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | L4331
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License Number State | TX
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