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General NPI Number Information
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NPI Number | 1306147210
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Entity Type | Organization
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Legal Business Name | ANDREW WINSLOW MCDANIEL, DMD, P.A.
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Dates
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Enumeration Date | 11/09/2010
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Last Update Date | 11/06/2015
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Provider Practice Location Address
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Address Line | 2811 S LOOP 289 STE 12
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City | LUBBOCK
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State | TX
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Zip | 79423-1488
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Country | US
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Telephone | 806-748-9797
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Fax | 806-748-9788
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Provider Business Mailing Address
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Address Line | 2811 S LOOP 289 STE 12
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City | LUBBOCK
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State | TX
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Zip | 79423-1488
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Country | US
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Telephone | 806-748-9797
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Fax | 806-748-9788
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW WINSLOW MCDANIEL
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Credential | DDS
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Telephone | 806-748-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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