Provider Demographics
NPI:1093927519
Name:KOTIN, ANDREW SAUL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SAUL
Last Name:KOTIN
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 1:252 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01540-2359
Mailing Address - Country:US
Mailing Address - Phone:508-987-8114
Mailing Address - Fax:
Practice Address - Street 1:252 MAIN STREET
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MA
Practice Address - Zip Code:01540-2359
Practice Address - Country:US
Practice Address - Phone:508-987-8114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA165551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice