Provider Demographics
NPI:1477074623
Name:ANDREWS, ALAN
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13622 GARFIELD ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-8844
Mailing Address - Country:US
Mailing Address - Phone:720-470-2705
Mailing Address - Fax:
Practice Address - Street 1:1408 S 3RD AVE
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-4650
Practice Address - Country:US
Practice Address - Phone:970-526-6544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002032381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice