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Organization

MOGOLLON FAMILY DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY ANDERSEN DO (DENTIST/ OWNER)
(928) 535-5886
Entity
Organization

Contact information

Practice address
3367 BUCKSKIN RD # 100, OVERGAARD, AZ 85933
(928) 535-5886
(928) 535-5887
Mailing address
PO BOX 100, OVERGAARD, AZ 85933-0100
(928) 535-5886
(928) 535-5887

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
07/27/2026
Last updated
07/27/2026
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