Provider Demographics
NPI:1841250990
Name:NIELD, ANDREW KEVIN (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:KEVIN
Last Name:NIELD
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 1:1952 S 1675 W
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:UT
Mailing Address - Zip Code:84075-8579
Mailing Address - Country:US
Mailing Address - Phone:801-825-3778
Mailing Address - Fax:
Practice Address - Street 1:1747 HERITAGE LN
Practice Address - Street 2:SUITE A-1
Practice Address - City:SYRACUSE
Practice Address - State:UT
Practice Address - Zip Code:84075-8552
Practice Address - Country:US
Practice Address - Phone:801-525-1415
Practice Address - Fax:801-525-0583
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT50358941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice