Individual
DR. ALTON GLENN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
910 WASHBURN AVE STE D, CORONA, CA 92882-4383
(951) 735-5460
(951) 735-1094
Mailing address
910 WASHBURN AVE STE D, CORONA, CA 92882-4383
(951) 735-5460
(951) 735-1094
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19406
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19406
DENTAL LICENSE
CA
Enumeration date
04/03/2007
Last updated
07/08/2007
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