Provider Demographics
NPI:1912155276
Name:SUBIDO, ANDREW SALVADOR (DDS)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:SALVADOR
Last Name:SUBIDO
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 1:505 W INDIANAPOLIS AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-4963
Mailing Address - Country:US
Mailing Address - Phone:559-346-0250
Mailing Address - Fax:
Practice Address - Street 1:401 TRINITY AVE
Practice Address - Street 2:
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610-2851
Practice Address - Country:US
Practice Address - Phone:559-665-1400
Practice Address - Fax:559-675-5224
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA574681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice