Individual
DR. MATTHEW ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5464 PINE LN, ROSCOE, IL 61073-7313
(815) 623-6000
Mailing address
5464 PINE LN, ROSCOE, IL 61073-7313
(815) 623-6000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030703
IL
Other
Enumeration date
04/26/2016
Last updated
12/30/2020
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