Individual
MR. WILLIAM R ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1152 S MAYO TRAIL, PIKEVILLE, KY 41501
(606) 432-0805
(606) 432-2946
Mailing address
972 BROADWAY PLAZA, PAINTSVILLE, KY 41240
(606) 789-1912
(606) 789-1939
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5386
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
5386
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60053865DENTAL
MEDICAID
KY
05
—
6405386MEDICAL
—
KY
Enumeration date
01/26/2007
Last updated
04/22/2008
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