Individual
BRAD ANDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
144 CALVARY LN, MOUNTAIN CITY, TN 37683-4306
(423) 727-0655
Mailing address
144 CALVARY LN, MOUNTAIN CITY, TN 37683-4306
(423) 727-0655
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D01443
OR
Other
Enumeration date
06/20/2016
Last updated
07/05/2022
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