Provider Demographics
NPI:1851502330
Name:STYGAR, ANDREW DWIGHT (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:DWIGHT
Last Name:STYGAR
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 1:637 S RANCHO SANTA FE RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-3973
Mailing Address - Country:US
Mailing Address - Phone:760-744-8199
Mailing Address - Fax:760-744-9162
Practice Address - Street 1:637 S RANCHO SANTA FE RD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-3973
Practice Address - Country:US
Practice Address - Phone:760-744-8199
Practice Address - Fax:760-744-9162
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA034225122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist