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General NPI Number Information
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NPI Number | 1518028703
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Entity Type | Organization
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Legal Business Name | ANDREW G. MITCHELL, INC.
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15991 MANCHESTER RD
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City | ELLISVILLE
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State | MO
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Zip | 63011-2140
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Country | US
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Telephone | 636-227-6945
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Fax |
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Provider Business Mailing Address
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Address Line | 31 SUMMERHILL LN
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City | TOWN AND COUNTRY
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State | MO
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Zip | 63017-8408
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Country | US
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Telephone | 314-878-4349
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ANDREW G. MITCHELL
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Credential |
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Telephone | 636-227-6945
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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 | 10793
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License Number State | MO
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