Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DS037509 | PA |
NPI | 1003165895 |
---|---|
Provider Name | Dr. Andrew Ian Fingeret |
First Address | Philadelphia, PA 19130-3201 |
Second Address | Jenkintown, PA 19046-3926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2012 |
Last Update Date | 07/09/2012 |