Provider Demographics
NPI:1619078318
Name:ARETAKIS, ANDREW GEORGE I (DDS, PC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:GEORGE
Last Name:ARETAKIS
Suffix:I
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1386 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-1349
Mailing Address - Country:US
Mailing Address - Phone:810-664-2235
Mailing Address - Fax:810-664-8904
Practice Address - Street 1:1386 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-1349
Practice Address - Country:US
Practice Address - Phone:810-664-2235
Practice Address - Fax:810-664-8904
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010161371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice