Provider Demographics
NPI:1760627863
Name:JOSEPH M. ANDREAS, D.M.D., PC
Entity type:Organization
Organization Name:JOSEPH M. ANDREAS, D.M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PRESIDENT ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ANDREAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-462-7060
Mailing Address - Street 1:21 HIGHLAND AVENUE
Mailing Address - Street 2:SUITE #6
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3872
Mailing Address - Country:US
Mailing Address - Phone:978-462-7060
Mailing Address - Fax:978-462-9388
Practice Address - Street 1:21 HIGHLAND AVENUE
Practice Address - Street 2:SUITE #6
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3872
Practice Address - Country:US
Practice Address - Phone:978-462-7060
Practice Address - Fax:978-462-9388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAT57144Medicare PIN