Individual
DR. JOHN O. ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
200 N HOMER ST, SUITE B, LANSING, MI 48912-4741
(517) 332-2259
Mailing address
200 N HOMER ST, SUITE B, LANSING, MI 48912-4741
(517) 332-2259
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10103
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4008295
—
MI
Enumeration date
10/26/2006
Last updated
07/08/2007
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