Individual
DR. DAVID CHARLES ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
430 MAIN ST, GREEN BAY, WI 54301-5115
(920) 431-0345
Mailing address
5318 NORTH ROSEMARY LANE, APPLETON, WI 54913
(920) 730-9027
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
5956
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33798200
—
WI
Enumeration date
08/08/2006
Last updated
07/08/2007
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