Individual
DR. BRUCE WILLIAM ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2725 FOX FARM RD, WORTHINGTON, MN 56187-3040
(507) 372-2869
Mailing address
2725 FOX FARM RD, WORTHINGTON, MN 56187-3040
(507) 372-2869
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8245
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
11/14/2019
Last updated
11/14/2019
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