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Individual

ANDREW JAMES KAWASAKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2953 BROAD AVE, MEMPHIS, TN 38112-2957
(901) 842-3171
Mailing address
1166 VAUGHN RD, MEMPHIS, TN 38122-1612
(701) 490-2137

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11591
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11591
DENTAL LICENSE NUMBER
TN
Enumeration date
02/25/2021
Last updated
07/29/2022
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