Provider Demographics
NPI:1255595732
Name:KNIGHT, ANDREW JOSEPH (DMD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JOSEPH
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 GLENEAGLES DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6404
Mailing Address - Country:US
Mailing Address - Phone:256-880-1884
Mailing Address - Fax:256-880-1886
Practice Address - Street 1:1108 GLENEAGLES DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6404
Practice Address - Country:US
Practice Address - Phone:256-880-1884
Practice Address - Fax:256-880-1886
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0005616122300000X
CO002024711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist