Organization
ANDERSON FAMILY DENTAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN DAVID ANDERSON DDS (OWNER)
(218) 245-1278
Entity
Organization
Contact information
Practice address
209 MCLEAN AVE, COLERAINE, MN 55722-0756
(218) 245-1278
(218) 245-1333
Mailing address
PO BOX 756, COLERAINE, MN 55722-0756
(218) 245-1278
(218) 245-1333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12543
MN
Other
Enumeration date
08/01/2012
Last updated
08/01/2012
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