# ANDREW J. DIETZ, DDS, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013261791
- **Authorized official:** ANDREW J. DIETZ DDS (OWNER)
- **Authorized official phone:** (856) 547-8664

## Contact information

- **Practice address:** 17 WHITE HORSE PIKE, SUITE 8, HADDON HEIGHTS, NJ 08035-1299
- **Practice address phone:** (856) 547-8664
- **Practice address fax:** (856) 547-5560
- **Mailing address:** 17 WHITE HORSE PIKE, SUITE 8, HADDON HEIGHTS, NJ 08035-1299
- **Mailing address phone:** (856) 547-8664
- **Mailing address fax:** (856) 547-5560

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0700X | Prosthodontics | 22DI01814600 | NJ | Yes |

## Other

- **Enumeration date:** 11/02/2012
- **Last updated:** 11/02/2012