Provider Demographics
NPI:1689100018
Name:LAMOTHE, ANDRE ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDRE
Middle Name:ROBERT
Last Name:LAMOTHE
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 1:337 EL DORADO ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4649
Mailing Address - Country:US
Mailing Address - Phone:831-373-2967
Mailing Address - Fax:
Practice Address - Street 1:770 E ROMIE LN STE G
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4222
Practice Address - Country:US
Practice Address - Phone:831-757-5291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-04
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN109261223G0001X
CA1062691223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice