Provider Demographics
NPI:1326467473
Name:POZO, ANDY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDY
Middle Name:
Last Name:POZO
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 1:1379 E VINE ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-3603
Mailing Address - Country:US
Mailing Address - Phone:407-933-8686
Mailing Address - Fax:407-933-2262
Practice Address - Street 1:1379 E VINE ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-3603
Practice Address - Country:US
Practice Address - Phone:407-933-8686
Practice Address - Fax:407-933-2262
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN278371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice