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General NPI Number Information
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NPI Number | 1457524845
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Entity Type | Organization
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Legal Business Name | ALBERT K. ANDREW II,DDS,PC
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 2759 US HIGHWAY 34
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City | OSWEGO
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State | IL
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Zip | 60543-8949
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Country | US
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Telephone | 630-554-2873
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Fax | 630-554-4574
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Provider Business Mailing Address
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Address Line | 2759 US HIGHWAY 34
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City | OSWEGO
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State | IL
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Zip | 60543-8949
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Country | US
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Telephone | 630-554-2873
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Fax | 630-554-4574
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Authorized Official
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Title or Position | CEO/OWNER
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Name | DR. ALBERT KIMBALL ANDREW II
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Credential | DDS
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Telephone | 630-554-2873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | IL
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