Provider Demographics
NPI:1285708206
Name:ROWE, ANDREW C (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:C
Last Name:ROWE
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 1:2238 SANTA CLARA AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-4463
Mailing Address - Country:US
Mailing Address - Phone:510-521-5141
Mailing Address - Fax:510-521-4493
Practice Address - Street 1:2238 SANTA CLARA AVE
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-4463
Practice Address - Country:US
Practice Address - Phone:510-521-5141
Practice Address - Fax:510-521-4493
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB27676-01OtherDENTICAL