# ANDERSON DENTAL

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

## Provider details

- **NPI number:** 1659625507
- **Authorized official:** LOREN P ANDERSON DDS (DENTIST/OWNER)
- **Authorized official phone:** (509) 585-2500

## Contact information

- **Practice address:** 4303 W 24TH AVE STE A, KENNEWICK, WA 99338-1963
- **Practice address phone:** (509) 585-2500
- **Practice address fax:** (509) 585-2503
- **Mailing address:** 4303 W 24TH AVE STE A, KENNEWICK, WA 99338-1963
- **Mailing address phone:** (509) 585-2500
- **Mailing address fax:** (509) 585-2503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE 9925 | WA | Yes |

## Other

- **Enumeration date:** 10/30/2012
- **Last updated:** 10/30/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1000256 | — | WA |