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Individual
DR. MATTHEW ROSS ANDERSON
Active
Individual
DR. MATTHEW ROSS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8418211-9921
UT
1223E0200X
Endodontics
D11375
OR
1223E0200X
Endodontics
Primary
DE60944562
WA
390200000X
Student in an Organized Health Care Education/Training Program
8418211-9921
UT
Other
Enumeration date
10/02/2012
Last updated
05/10/2021
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