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General NPI Number Information
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NPI Number | 1972912301
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Entity Type | Individual
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Provider Name | MATTHEW LEE ANDREWS D.M.D
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Gender | Male
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 155A HALTON VILLAGE CIR
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City | GREENVILLE
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State | SC
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Zip | 29607-6825
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Country | US
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Telephone | 803-609-0551
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Fax |
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Provider Business Mailing Address
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Address Line | 155A HALTON VILLAGE CIR
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City | GREENVILLE
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State | SC
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Zip | 29607-6825
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Country | US
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Telephone | 803-609-0551
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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 | 8389
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 8389
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License Number State | SC
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