# MOGOLLON FAMILY DENTISTRY

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

## Provider details

- **NPI number:** 1699696229
- **Authorized official:** DR. JEFFREY ANDERSEN DDS (DENTIST/ OWNER)
- **Authorized official phone:** (928) 535-5886

## Contact information

- **Practice address:** 3367 BUCKSKIN RD, OVERGAARD, AZ 85933-3298
- **Practice address phone:** (928) 535-5886
- **Practice address fax:** (928) 535-5887
- **Mailing address:** 3367 BUCKSKIN RD \# 100, OVERGAARD, AZ 85933-3298
- **Mailing address phone:** (928) 535-5886
- **Mailing address fax:** (928) 535-5887

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2026
- **Last updated:** 07/27/2026