Provider Demographics
NPI:1598970139
Name:ANDREWS, ANTON GEORGE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTON
Middle Name:GEORGE
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 KENNEDY DR APT 404
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-3439
Mailing Address - Country:US
Mailing Address - Phone:617-880-9989
Mailing Address - Fax:
Practice Address - Street 1:747 W MAIN ST
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:MA
Practice Address - Zip Code:02322-1746
Practice Address - Country:US
Practice Address - Phone:508-587-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice