Provider Demographics
NPI:1811260003
Name:HOLSTEIN, ANDREA B (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:B
Last Name:HOLSTEIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3207 FRYMAN RD
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-4115
Mailing Address - Country:US
Mailing Address - Phone:818-761-8851
Mailing Address - Fax:818-761-8851
Practice Address - Street 1:10921 WILSHIRE BLVD
Practice Address - Street 2:SUITE 807
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-3906
Practice Address - Country:US
Practice Address - Phone:310-209-5050
Practice Address - Fax:310-209-5550
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA486111223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics