# MISSISSIPPI VALLEY ORAL & MAXILLOFACIAL SURGERY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144490707
- **Authorized official:** DR. DAVID A ANDERSON DDS (OWNER/DOCTOR)
- **Authorized official phone:** (563) 355-9424

## Contact information

- **Practice address:** 2305 E 52ND ST, SUITE 1, DAVENPORT, IA 52807-2762
- **Practice address phone:** (563) 355-9424
- **Practice address fax:** (563) 355-0180
- **Mailing address:** 2305 E 52ND ST, SUITE 1, DAVENPORT, IA 52807-2762
- **Mailing address phone:** (563) 355-9424
- **Mailing address fax:** (563) 355-0180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 7637 | IA | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 7766 | IA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 7839 | IA | — |

## Other

- **Enumeration date:** 03/10/2008
- **Last updated:** 03/11/2008