Individual
FARRAH L ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1619 W US HIGHWAY 24, INDEPENDENCE, MO 64050-2345
(816) 461-0055
Mailing address
1619 W US HIGHWAY 24, INDEPENDENCE, MO 64050-2345
(816) 461-0055
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60429
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200386640A
—
KS
Enumeration date
08/09/2006
Last updated
12/19/2012
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