Individual
ANDREW BOTROUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DENTAL STUDENT
Contact information
Practice address
4997 N TWIN CITY HWY, PORT ARTHUR, TX 77642-5845
(409) 548-0685
Mailing address
187 VASSAR ST, STATEN ISLAND, NY 10314-6034
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
36048
TX
Other
Enumeration date
12/19/2018
Last updated
07/30/2020
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