Organization
ANDERSON DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEON ANDERSON JR. D.M.D. (OWNER)
(601) 366-1112
Entity
Organization
Contact information
Practice address
514-D EAST WOODROW WILSON DR., JACKSON, MS 39216-4538
(601) 366-1112
(601) 366-6092
Mailing address
P.O. BOX 11277, JACKSON, MS 39283-1277
(601) 366-1112
(601) 366-6092
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
MS2164-85
MS
Other
Enumeration date
03/22/2007
Last updated
08/22/2020
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