Individual
DR. DAVID PAUL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2700 MARTIN LUTHER KING JR BLVD, DETROIT, MI 48208-2576
(313) 494-6779
Mailing address
282 BURLINGTON RD, TECUMSEH, ONTARIO N8N 1-H4
(519) 735-9559
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901018789
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901018789
MICHIGAN DENTAL LICENSE
MI
Enumeration date
06/26/2013
Last updated
06/26/2013
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