Provider Demographics
NPI:1942345699
Name:AGNINI, ANDREW PIERCE (DDS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:PIERCE
Last Name:AGNINI
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 1:1805 LAKELAND HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-3062
Mailing Address - Country:US
Mailing Address - Phone:863-682-1500
Mailing Address - Fax:863-682-6318
Practice Address - Street 1:1805 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-3062
Practice Address - Country:US
Practice Address - Phone:863-682-1500
Practice Address - Fax:863-682-6318
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL166461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice