Provider Demographics
NPI:1205233137
Name:SKLAR, ANDREW MALCOLM (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MALCOLM
Last Name:SKLAR
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 1:4901 SEMINARY RD #120
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1897
Mailing Address - Country:US
Mailing Address - Phone:703-931-3141
Mailing Address - Fax:703-845-1512
Practice Address - Street 1:4901 SEMINARY RD #120
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1897
Practice Address - Country:US
Practice Address - Phone:703-931-3141
Practice Address - Fax:703-845-1512
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010044881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice