Individual
MRS. JEAN ELLEN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1789 WOODLANE DRIVE, SUITE D, WOODBURY, MN 55125
(651) 738-1284
Mailing address
9098 JENSEN AVE SOUTH, COTTAGE GROVE, MN 55016
(651) 459-4632
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H5261
MN
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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