Individual
DR. ANDREW SOUTAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
139 FLATBUSH AVE, SUITE 10, BROOKLYN, NY 11217-1450
(718) 622-7637
(718) 622-7637
Mailing address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0587371
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/26/2015
Last updated
01/13/2017
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