Provider Demographics
NPI:1992908255
Name:ATCHISON, ANDREW STEVEN (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:STEVEN
Last Name:ATCHISON
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 1:2121 HIGHWAY 10 E
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-2559
Mailing Address - Country:US
Mailing Address - Phone:218-236-7076
Mailing Address - Fax:218-236-4999
Practice Address - Street 1:2121 HIGHWAY 10 E
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-2559
Practice Address - Country:US
Practice Address - Phone:218-236-7076
Practice Address - Fax:218-236-4999
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND124041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice