Provider Demographics
NPI:1154774859
Name:READ, ANDREA (RDH, MSDH)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:READ
Suffix:
Gender:F
Credentials:RDH, MSDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 435
Mailing Address - Street 2:
Mailing Address - City:FORESTDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02644-0435
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14 JAN SEBASTIAN DR
Practice Address - Street 2:#C
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-2384
Practice Address - Country:US
Practice Address - Phone:508-364-5134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13058124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist