Provider Demographics
NPI:1336557826
Name:MAHLER, ANDREW LAURENCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LAURENCE
Last Name:MAHLER
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 1:1755 ERRINGER RD
Mailing Address - Street 2:SUITE 21
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-6507
Mailing Address - Country:US
Mailing Address - Phone:805-522-7370
Mailing Address - Fax:
Practice Address - Street 1:1755 ERRINGER RD
Practice Address - Street 2:SUITE 21
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-6507
Practice Address - Country:US
Practice Address - Phone:805-522-7370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA637391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice