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General NPI Number Information
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NPI Number | 1316232432
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Entity Type | Organization
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Legal Business Name | ANDREW K JOHN DDS INC
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Dates
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Enumeration Date | 06/16/2011
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Last Update Date | 06/21/2011
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Provider Practice Location Address
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Address Line | 2123 S EL CAMINO REAL
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City | OCEANSIDE
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State | CA
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Zip | 92054-6271
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Country | US
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Telephone | 760-757-7720
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Fax |
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Provider Business Mailing Address
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Address Line | 2123 S EL CAMINO REAL
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City | OCEANSIDE
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State | CA
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Zip | 92054-6271
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Country | US
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Telephone | 760-757-7720
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SUSIE HERNANDEZ
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Credential |
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Telephone | 760-757-7720
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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 | 56037
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License Number State | CA
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