Provider Demographics
NPI:1043471303
Name:ESTILL, ANDREW ROBERT (DDS)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:ROBERT
Last Name:ESTILL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 HUGUENOT RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-2427
Mailing Address - Country:US
Mailing Address - Phone:804-794-9789
Mailing Address - Fax:
Practice Address - Street 1:6510 HARBOUR VIEW CT
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-6559
Practice Address - Country:US
Practice Address - Phone:804-739-6500
Practice Address - Fax:804-739-4064
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412545122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist