Provider Demographics
NPI:1992703144
Name:KENNETH L ANDOW, DDS, PC
Entity type:Organization
Organization Name:KENNETH L ANDOW, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANDOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-799-1525
Mailing Address - Street 1:9025 E MINERAL CIR
Mailing Address - Street 2:STE 101
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3468
Mailing Address - Country:US
Mailing Address - Phone:303-799-1525
Mailing Address - Fax:303-799-4870
Practice Address - Street 1:9025 E MINERAL CIR
Practice Address - Street 2:STE 101
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3468
Practice Address - Country:US
Practice Address - Phone:303-799-1525
Practice Address - Fax:303-799-4870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1054021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty