Provider Demographics
NPI:1265866784
Name:MCDONALD, ANDREW LAWRENCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LAWRENCE
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17705 HALE AVE
Mailing Address - Street 2:SUITE A1
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-4340
Mailing Address - Country:US
Mailing Address - Phone:408-779-9335
Mailing Address - Fax:669-333-5755
Practice Address - Street 1:17705 HALE AVE
Practice Address - Street 2:SUITE A1
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-4340
Practice Address - Country:US
Practice Address - Phone:408-779-9335
Practice Address - Fax:408-782-1087
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA625741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice