Organization
ANDERSON ORTHODONTICS
Active
Organization
ANDERSON ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON A ANDERSON DDS MS (ORTHODONTIST)
(507) 665-3394
Entity
Organization
Contact information
Practice address
302 VALLEY GREEN SQ, LE SUEUR, MN 56058-1943
(507) 665-3394
(507) 665-4286
Mailing address
17570 HACKBERRY CT, EDEN PRAIRIE, MN 55347-4271
(952) 486-7674
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9178768
—
MN
Enumeration date
04/01/2008
Last updated
04/01/2008
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