Individual
DR. TIMOTHY ALWORTH ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
2059 ROBERT ST S, WEST ST PAUL, MN 55118-3924
(651) 457-9633
Mailing address
1362 PRESTON LN, SHAKOPEE, MN 55379-7071
(612) 619-0917
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13133
MN
Other
Enumeration date
04/20/2011
Last updated
06/28/2012
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