Individual
MICHAEL ANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-6700
Mailing address
2900 DOOLITTLE DR, ELLSWORTH AFB, SD 57706-4821
(605) 385-3394
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.026212
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
291515
MILITARY
—
Enumeration date
07/15/2020
Last updated
07/27/2023
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