Individual
DR. GREGORY EARL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1395 NO. 400 E., STE B, LOGAN, UT 84341
(435) 755-5000
(435) 755-5099
Mailing address
1395 NO 400 E., STE B, LOGAN, UT 84341
(435) 755-5000
(435) 755-5099
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
145198-9924
UT
2086S0122X
Plastic and Reconstructive Surgery Physician
1451989924
UT
Other
Enumeration date
04/16/2007
Last updated
02/18/2014
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