Provider Demographics
NPI:1144844192
Name:ANDREY ENG DDS INC
Entity type:Organization
Organization Name:ANDREY ENG DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:ENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-779-2736
Mailing Address - Street 1:20397 YORBA LINDA BLVD
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3062
Mailing Address - Country:US
Mailing Address - Phone:714-779-2736
Mailing Address - Fax:714-779-5739
Practice Address - Street 1:20397 YORBA LINDA BLVD
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-3062
Practice Address - Country:US
Practice Address - Phone:714-779-2736
Practice Address - Fax:714-779-5739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental