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Organization
SRA DDS
Active
Organization
SRA DDS
Active
Other names
SRA DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT ROBERT ANDERSON DDS (OWNER)
(218) 365-3194
Entity
Organization
Contact information
Practice address
33 E CHAPMAN ST, ELY, MN 55731-1227
(218) 365-3194
(218) 365-5613
Mailing address
33 E CHAPMAN ST, ELY, MN 55731-1227
(218) 365-3194
(218) 365-5613
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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