MEDICARE: JAMES P MCANDREWS D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	38089	CA
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DN12391	GA

General Provider Information

NPI Number	:	1477626182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES P MCANDREWS D.D.S.

Provider Business Mailing Address
First Line	:	1463 KLONDIKE RD SW STE C
Second Line	:
City	:	CONYERS
State	:	GA
Zip	:	30094-5127
Country	:	US
Telephone Number	:	770-483-9692
Fax Number	:	770-922-8603

Provider Business Practice Location Address
First Line	:	5243 SNAPFINGER WOODS DR STE 106
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30035-4000
Country	:	US
Telephone Number	:	770-981-9400
Fax Number	:	709-878-7207

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	02/27/2024

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