Provider Demographics
NPI:1376774968
Name:FINE, ANDREW D (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:D
Last Name:FINE
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 1:301 MILL RD
Mailing Address - Street 2:SUITE(U7)
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1291
Mailing Address - Country:US
Mailing Address - Phone:516-374-2293
Mailing Address - Fax:516-374-3387
Practice Address - Street 1:301 MILL RD
Practice Address - Street 2:SUITE(U7)
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1291
Practice Address - Country:US
Practice Address - Phone:516-374-2293
Practice Address - Fax:516-374-3387
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0388341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice