Provider Demographics
NPI:1720455686
Name:FLORES HIDALGO, ANDRES DAVID (DDS, MS)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:DAVID
Last Name:FLORES HIDALGO
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Mailing Address - Street 1:PO BOX 630579
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0579
Mailing Address - Country:US
Mailing Address - Phone:513-245-3301
Mailing Address - Fax:513-245-8721
Practice Address - Street 1:222 PIEDMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-4231
Practice Address - Country:US
Practice Address - Phone:513-475-8783
Practice Address - Fax:513-475-7698
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2061223P0106X
OH30.000000204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology