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Individual
DR. JAY ROSAMOND ANDERSON
Active
Individual
DR. JAY ROSAMOND ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4887
KY
122300000X
Dentist
DF0027
OR
122300000X
Dentist
DN1856087
MA
1223G0001X
General Practice Dentistry
Primary
101391
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CA
Enumeration date
07/16/2012
Last updated
06/02/2017
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