Provider Demographics
NPI:1437233202
Name:ANDREWS & BAKER, LLC
Entity Type:Organization
Organization Name:ANDREWS & BAKER, LLC
Other - Org Name:SOUTHEASTERN ENDODONTICS LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-352-2289
Mailing Address - Street 1:911 E 67TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4612
Mailing Address - Country:US
Mailing Address - Phone:912-352-2289
Mailing Address - Fax:912-352-2042
Practice Address - Street 1:911 E 67TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4612
Practice Address - Country:US
Practice Address - Phone:912-352-2289
Practice Address - Fax:912-352-2042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA79841223E0200X
GA0120791223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GABB4957203OtherDEA REG. NO.
GAAA9154078OtherDEA REG. NO.