Provider Demographics
NPI:1154500247
Name:BELL, ANDREA M (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:M
Last Name:BELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 ROYAL VISTA BLVD STE A100
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-1149
Mailing Address - Country:US
Mailing Address - Phone:314-853-1978
Mailing Address - Fax:
Practice Address - Street 1:625 EL GUSTO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-2517
Practice Address - Country:US
Practice Address - Phone:314-853-1978
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0414981223D0004X
TX366801223D0004X
NY05488211223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist