Provider Demographics
NPI:1750477063
Name:ACHORD, ANDREW P (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:P
Last Name:ACHORD
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 1:4290 LAKELAND DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9571
Mailing Address - Country:US
Mailing Address - Phone:601-664-0492
Mailing Address - Fax:601-936-5770
Practice Address - Street 1:4290 LAKELAND DR
Practice Address - Street 2:SUITE C
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9571
Practice Address - Country:US
Practice Address - Phone:601-664-0492
Practice Address - Fax:601-936-5770
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3202-011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice