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Organization
RYAN T ANDERSON DDC PC
Active
Organization
RYAN T ANDERSON DDC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN ANDERSON D.D.S (GENERAL DENTIST)
(719) 384-9442
Entity
Organization
Contact information
Practice address
13 E 4TH ST., LA JUNTA, CO 81050
(719) 384-9442
Mailing address
13 E 4TH ST, LA JUNTA, CO 81050-3601
(719) 384-9442
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
00202659
CO
Other
Enumeration date
11/05/2015
Last updated
02/15/2019
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