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Organization
MICHAEL J. ANDRESKI, DDS, PA
Active
Organization
MICHAEL J. ANDRESKI, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY CAROL ANDRESKI (SECRETARY/TREASURER)
(336) 667-1029
Entity
Organization
Contact information
Practice address
1511 RIVER ST, WILKESBORO, NC 28697-7391
(336) 667-1029
(336) 667-4155
Mailing address
1511 RIVER ST, WILKESBORO, NC 28697-7391
(336) 667-1029
(336) 667-4155
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5790
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890106B
—
NC
01
—
U39031
MEDICAID UPIN
NC
Enumeration date
08/23/2007
Last updated
08/23/2007
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