Individual
DR. ANDREW KOKANOUTRANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7448 W GLENDALE AVE STE 126, GLENDALE, AZ 85303-2546
(623) 930-0060
Mailing address
22015 N 28TH PL, PHOENIX, AZ 85050-8222
(949) 232-7309
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D010057
AZ
Other
Enumeration date
06/20/2018
Last updated
03/18/2022
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