# ANDERSON DENTAL CLINIC

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

## Provider details

- **NPI number:** 1922246537
- **Authorized official:** CHARLES W ANDERSON D.D.S (OWNER/PRESIDENT)
- **Authorized official phone:** (512) 264-9977

## Contact information

- **Practice address:** 22106 HWY 71 W, SPICEWOOD, TX 78669-6115
- **Practice address phone:** (512) 264-9977
- **Practice address fax:** (512) 264-9517
- **Mailing address:** 22106 HWY 71 W, SPICEWOOD, TX 78669-6115
- **Mailing address phone:** (512) 264-9977
- **Mailing address fax:** (512) 264-9517

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 9754 | TX | Yes |

## Other

- **Enumeration date:** 02/04/2009
- **Last updated:** 02/04/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 007989902 | — | TX |