Individual
DR. JACOB MATTHEW ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
300 SE 2ND ST STE 200, LEES SUMMIT, MO 64063-2759
(816) 524-6300
Mailing address
300 SE 2ND ST STE 200, LEES SUMMIT, MO 64063-2759
(816) 524-6300
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2014016763
MO
Other
Enumeration date
08/07/2014
Last updated
01/02/2021
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