Individual
DAVID PAUL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
555 RIVERGATE, B1-109, DURANGO, CO 81301-7470
(970) 422-8498
(970) 422-8498
Mailing address
555 RIVERGATE, B1-109, DURANGO, CO 81301-7470
(970) 422-8498
(970) 422-8498
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2901015674
MI
1223G0001X
General Practice Dentistry
Primary
DEN.00202432
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15674
BLUE CROSS BLUE SHIELD
MI
05
—
3250025
—
MI
Enumeration date
05/18/2007
Last updated
06/08/2016
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