Provider Demographics
NPI:1134329261
Name:ANDREWS, TODD BRANDON
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:BRANDON
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 F ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-3844
Mailing Address - Country:US
Mailing Address - Phone:916-452-6772
Mailing Address - Fax:916-455-2132
Practice Address - Street 1:3031 F STREET SUITE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5248
Practice Address - Country:US
Practice Address - Phone:916-452-6772
Practice Address - Fax:916-455-2132
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA476841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice