Individual
ANDREW M DEWITT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
100 BRYANT ST, DUBUQUE, IA 52003-7405
(563) 557-1440
(563) 557-7001
Mailing address
100 BRYANT ST, DUBUQUE, IA 52003-7405
(563) 557-1440
(563) 557-7001
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
07863
IA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
4971015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0231696
—
IA
01
—
28203
BCBS
IA
05
—
33766100
—
WI
Enumeration date
09/08/2005
Last updated
07/08/2007
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