Provider Demographics
NPI:1801911847
Name:BESSENROTH, ANDREAS UDO (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREAS
Middle Name:UDO
Last Name:BESSENROTH
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 1:4512 N FLAGLER DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-3839
Mailing Address - Country:US
Mailing Address - Phone:561-845-1818
Mailing Address - Fax:561-845-1801
Practice Address - Street 1:4512 N FLAGLER DR
Practice Address - Street 2:SUITE 203
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-3839
Practice Address - Country:US
Practice Address - Phone:561-845-1818
Practice Address - Fax:561-845-1801
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN14155122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist