Organization
DENTISTS IN LAWRENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUSTIN R ANDERSON DDS (OWNER)
(785) 843-6060
Entity
Organization
Contact information
Practice address
831 VERMONT ST, LAWRENCE, KS 66044-2665
(785) 843-6060
(785) 843-4335
Mailing address
831 VERMONT ST, LAWRENCE, KS 66044-2665
(785) 843-6060
(785) 843-4335
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29713015
BCBS OF KC PROVIDER NUMBE
MO
01
—
420743
BCBS OF KS PROVIDER NUMBE
KS
Enumeration date
08/30/2006
Last updated
01/23/2024
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