Individual
DR. JOHN MARK ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
530 W PLEASANT ST, MANKATO, MN 56001-0438
(507) 345-6478
Mailing address
4206 FAIRVIEW LN, MADISON LAKE, MN 56063-9515
(507) 243-3888
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10259
MN
Other
Enumeration date
12/20/2006
Last updated
07/08/2007
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