Individual
PRISCILLA ANDALIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3458 NEELY RD, JOINT BASE MDL, NJ 08641-5312
(609) 754-9297
Mailing address
317 MILLER HILL RD, CARMEL, NY 10512-3307
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS042774
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/28/2020
Last updated
08/31/2021
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