Provider Demographics
NPI:1982613139
Name:ANDRESEN, DENNIS R (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:R
Last Name:ANDRESEN
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 1:750 E ROMIE LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4210
Mailing Address - Country:US
Mailing Address - Phone:831-424-0881
Mailing Address - Fax:831-424-1026
Practice Address - Street 1:750 E ROMIE LN
Practice Address - Street 2:SUITE B
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4210
Practice Address - Country:US
Practice Address - Phone:831-424-0881
Practice Address - Fax:831-424-1026
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA195831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice