Organization
CDE VENTURE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN CRAIG ANDERSON DDS, MS (OWNER)
(801) 891-5580
Entity
Organization
Contact information
Practice address
2578 IDAHO ST, ELKO, NV 89801-4601
(775) 299-4790
(775) 738-0495
Mailing address
6339 S VINECREST DR, SALT LAKE CITY, UT 84121-2426
(801) 891-5520
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/30/2019
Last updated
04/30/2019
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