Individual
DR. MATTHEW ROSS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
14400 NE 20TH AVE STE 100, VANCOUVER, WA 98686-1412
(360) 576-5066
Mailing address
14400 NE 20TH AVE STE 100, VANCOUVER, WA 98686-1412
(360) 576-5066
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8418211-9921
UT
1223E0200X
Endodontics
D11375
OR
1223E0200X
Endodontics
Primary
DE60944562
WA
390200000X
Student in an Organized Health Care Education/Training Program
8418211-9921
UT
Other
Enumeration date
10/02/2012
Last updated
05/10/2021
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