Provider Demographics
NPI:1124078522
Name:ANDREWS, PAUL ADAM (DDS, PHD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ADAM
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:DDS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7352 STONEROCK CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8000
Mailing Address - Country:US
Mailing Address - Phone:407-351-0575
Mailing Address - Fax:407-363-6945
Practice Address - Street 1:7352 STONEROCK CIR
Practice Address - Street 2:SUITE A
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8000
Practice Address - Country:US
Practice Address - Phone:407-351-0575
Practice Address - Fax:407-363-6945
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN6708122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1124078522Medicare PIN