Provider Demographics
NPI:1689293292
Name:ANDREW FREY, DDS, PLLC
Entity Type:Organization
Organization Name:ANDREW FREY, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:FREY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-252-0408
Mailing Address - Street 1:9131 COLLEGE PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-4827
Mailing Address - Country:US
Mailing Address - Phone:239-437-8900
Mailing Address - Fax:
Practice Address - Street 1:9131 COLLEGE PKWY STE 150
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-4827
Practice Address - Country:US
Practice Address - Phone:239-437-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental