Individual
DR. PAUL DANIEL ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4778 BANNING AVE, WHITE BEAR LAKE, MN 55110-3264
(651) 426-8998
Mailing address
399 LOCUST ST, MAHTOMEDI, MN 55115
(651) 653-5283
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9267
MN
Other
Enumeration date
12/02/2006
Last updated
07/08/2007
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