Provider Demographics
NPI:1043386543
Name:ROMERO, ANDREW D (DDS PS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:D
Last Name:ROMERO
Suffix:
Gender:M
Credentials:DDS PS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19110 BOTHELL WAY NE
Mailing Address - Street 2:STE. 101
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-2970
Mailing Address - Country:US
Mailing Address - Phone:425-482-9211
Mailing Address - Fax:425-482-2011
Practice Address - Street 1:19110 BOTHELL WAY NE
Practice Address - Street 2:STE. 101
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-2970
Practice Address - Country:US
Practice Address - Phone:425-482-9211
Practice Address - Fax:425-482-2011
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA83021223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics