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Organization

WILLIAM R ANDERSON DMD PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WILLIAM R ANDERSON DMD (PRESIDENT)
(606) 789-1912
Entity
Organization

Contact information

Practice address
972 BROADWAY PLAZA, PAINTSVILLE, KY 41240
(606) 789-1912
(606) 789-1939
Mailing address
972 BROADWAY PLAZA, PAINTSVILLE, KY 41240
(606) 789-1912
(606) 789-1939

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
5386
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60053865
KY
05
64053861
KY
Enumeration date
02/23/2007
Last updated
03/12/2008
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