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General NPI Number Information
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NPI Number | 1811388184
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Entity Type | Individual
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Provider Name | KEVIN MICHAEL ANDREWS D.M.D
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Gender | Male
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Dates
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Enumeration Date | 02/09/2015
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 1067 TWINING DR BLDG 4666
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City | BARKSDALE AFB
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State | LA
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Zip | 71110-2486
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Country | US
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Telephone | 210-292-9038
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Fax |
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Provider Business Mailing Address
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Address Line | 1067 TWINING DR BLDG 4666
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City | BARKSDALE AFB
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State | LA
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Zip | 71110-2486
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Country | US
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Telephone |
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Fax |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 38207
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | S3-322
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License Number State | NV
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