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General NPI Number Information
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NPI Number | 1831828268
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Entity Type | Individual
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Provider Name | ANDREA MARIA VASQUEZ DMD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 715 W WHEATLAND RD
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City | DUNCANVILLE
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State | TX
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Zip | 75116-4520
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Country | US
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Telephone | 972-298-0347
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Fax |
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Provider Business Mailing Address
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Address Line | 10 ADDISON CT
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City | MANSFIELD
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State | TX
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Zip | 76063-5511
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Country | US
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Telephone | 469-601-0929
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN.00205138
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 40404
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License Number State | TX
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