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General NPI Number Information
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NPI Number | 1457473100
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Entity Type | Organization
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Legal Business Name | KEVIN J ANDREWS DDS MS A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2125 GREEN VISTA DR #104
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City | SPARKS
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State | NV
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Zip | 89431
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Country | US
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Telephone | 775-674-1444
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Fax | 775-674-1515
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Provider Business Mailing Address
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Address Line | 2125 GREEN VISTA DR #104
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City | SPARKS
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State | NV
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Zip | 89431
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Country | US
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Telephone | 775-674-1444
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Fax | 775-674-1515
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | KEVIN JAY ANDREWS
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Credential | DDS MS
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Telephone | 775-674-1444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | NE 2766 SPEC S345
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License Number State | NE
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