Provider Demographics
NPI:1033347497
Name:GAERTNER, ANDY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:
Last Name:GAERTNER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ARTHUR GODFREY ROAD
Mailing Address - Street 2:SUITE #500
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140
Mailing Address - Country:US
Mailing Address - Phone:305-531-6646
Mailing Address - Fax:305-531-1064
Practice Address - Street 1:400 ARTHUR GODFREY ROAD
Practice Address - Street 2:SUITE #500
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140
Practice Address - Country:US
Practice Address - Phone:305-531-6646
Practice Address - Fax:305-531-1064
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 18314122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist