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General NPI Number Information
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NPI Number | 1568690360
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Entity Type | Individual
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Provider Name | ANDREA L EARNEST DDS
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Gender | Female
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 05/16/2012
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Provider Practice Location Address
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Address Line | 114 MINNIE ST SUITE C
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City | FAIRBANKS
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State | AK
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Zip | 99701-3006
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Country | US
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Telephone | 907-456-4580
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Fax | 907-456-4588
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Provider Business Mailing Address
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Address Line | 114 MINNIE ST SUITE C
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City | FAIRBANKS
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State | AK
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Zip | 99701-3006
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Country | US
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Telephone | 907-456-4580
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Fax | 907-456-4588
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1299
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License Number State | AK
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