Provider Demographics
NPI:1326348046
Name:BITTER, ANDREW N (DDS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:N
Last Name:BITTER
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 1:1943 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2028
Mailing Address - Country:US
Mailing Address - Phone:801-226-0441
Mailing Address - Fax:801-226-4754
Practice Address - Street 1:1943 N STATE ST
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-2028
Practice Address - Country:US
Practice Address - Phone:801-226-0441
Practice Address - Fax:801-226-4754
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT91585041223G0001X
WI6665-151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice