# ANDREW EUGENE PAK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1215553565
- **Gender:** Man
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 38130 | TX | Yes |
| 1223G0001X | General Practice Dentistry | D010719 | AZ | — |

## Other

- **Enumeration date:** 06/23/2020
- **Last updated:** 04/07/2022