Provider Demographics
NPI:1528108289
Name:SOHN, ANDREW M (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:M
Last Name:SOHN
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Gender:M
Credentials:DMD, MD
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Mailing Address - Street 1:2800 HWY 114 FTONTAGE RD
Mailing Address - Street 2:SUITE 340
Mailing Address - City:TROPHY CLUB
Mailing Address - State:TX
Mailing Address - Zip Code:76262
Mailing Address - Country:US
Mailing Address - Phone:817-490-9979
Mailing Address - Fax:817-490-9979
Practice Address - Street 1:2800 STATE HIGHWAY 114
Practice Address - Street 2:SUITE 340
Practice Address - City:TROPHY CLUB
Practice Address - State:TX
Practice Address - Zip Code:76262
Practice Address - Country:US
Practice Address - Phone:817-490-9979
Practice Address - Fax:817-490-1442
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2012-06-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX190561223S0112X
TXN9961204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery