Individual
DR. BENJAMIN JAMES ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.
Contact information
Practice address
14625 CALIFORNIA ST, OMAHA, NE 68154-1950
(402) 397-7777
Mailing address
2309 N 179TH ST, OMAHA, NE 68116-2261
(417) 987-0106
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6780
NE
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6780
NE
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
PRV-TP-111-09
MS
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
T-2530
MS
Other
Enumeration date
07/01/2008
Last updated
11/30/2016
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