Individual
DR. ANDREW CHARLES COALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
825 WASHINGTON ST, WATERTOWN, NY 13601
(315) 788-4750
Mailing address
825 WASHINGTON ST, WATERTOWN, NY 13601-4033
(315) 788-4750
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401414485
VA
122300000X
Dentist
Primary
059670
NY
Other
Enumeration date
08/06/2014
Last updated
06/19/2018
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