Individual
DR. ANDREA J BOTAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1575 BROADWAY, HEWLETT, NY 11557-1457
(516) 710-8547
(516) 764-3062
Mailing address
1575 BROADWAY, HEWLETT, NY 11557-1457
(516) 710-8547
(516) 764-3062
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
043726
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120730021
—
NY
Enumeration date
09/08/2011
Last updated
09/08/2015
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