Individual
RYAN TAYLOR ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
13 EAST 4TH STREET, LA JUNTA, CO 81050
(719) 384-9442
(719) 384-9446
Mailing address
13 EAST 4TH STREET, LA JUNTA, CO 81050
(719) 384-9442
(719) 384-9446
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00202659
CO
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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