Basic Information
Provider Information
NPI: 1053708487
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRENCH
FirstName: ANDREW
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: DDS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 16111 PLUMMER ST
Address2:  
City: NORTH HILLS
State: CA
PostalCode: 913432036
CountryCode: US
TelephoneNumber: 8188917711
FaxNumber:  
Practice Location
Address1: 16111 PLUMMER ST
Address2:  
City: NORTH HILLS
State: CA
PostalCode: 913432036
CountryCode: US
TelephoneNumber: 8188917711
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/23/2015
LastUpdateDate: 04/23/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X63957CAY Dental ProvidersDentist 

No ID Information.


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