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General NPI Number Information
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NPI Number | 1972910537
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Entity Type | Individual
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Provider Name | ANDREA LEWIS-MCKENZIE DMD
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Gender | Female
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Dates
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Enumeration Date | 07/16/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 7744 PETERS RD
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City | PLANTATION
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State | FL
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Zip | 33324-4004
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Country | US
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Telephone | 954-951-0181
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 770112
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City | CORAL SPRINGS
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State | FL
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Zip | 33077-0112
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Country | US
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Telephone | 954-951-0181
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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 | DN20754
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License Number State | FL
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