Individual
PATRICIA ELIZABETH ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3718 GRUBER RD BLDG H, FORT BRAGG, NC 28310-8934
(910) 396-1571
Mailing address
2917 LAMBRUSCO PL, FAYETTEVILLE, NC 28306-9282
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
7168
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2222222222
MILITARY
—
Enumeration date
10/07/2019
Last updated
10/07/2019
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