Organization
DR. THANE B. ANDERSON, DDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THANE B ANDERSON DDS (OWNER)
(608) 873-3213
Entity
Organization
Contact information
Practice address
1520 VERNON ST, STOUGHTON, WI 53589-2260
(608) 873-3213
(608) 873-7254
Mailing address
1520 VERNON ST, STOUGHTON, WI 53589-2260
(608) 873-3213
(608) 873-7254
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4812W
WI
Other
Enumeration date
07/26/2007
Last updated
06/21/2018
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