# MICHAEL J. ANDRESKI, DDS, PA

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

## Provider details

- **NPI number:** 1710170634
- **Authorized official:** MRS. MARY CAROL ANDRESKI (SECRETARY/TREASURER)
- **Authorized official phone:** (336) 667-1029

## Contact information

- **Practice address:** 1511 RIVER ST, WILKESBORO, NC 28697-7391
- **Practice address phone:** (336) 667-1029
- **Practice address fax:** (336) 667-4155
- **Mailing address:** 1511 RIVER ST, WILKESBORO, NC 28697-7391
- **Mailing address phone:** (336) 667-1029
- **Mailing address fax:** (336) 667-4155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5790 | NC | Yes |

## Other

- **Enumeration date:** 08/23/2007
- **Last updated:** 08/23/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 890106B | — | NC |
| 01 | — | U39031 | MEDICAID UPIN | NC |