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Organization

ANDERSON DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LOREN P ANDERSON DDS (DENTIST/OWNER)
(509) 585-2500
Entity
Organization

Contact information

Practice address
4303 W 24TH AVE STE A, KENNEWICK, WA 99338-1963
(509) 585-2500
(509) 585-2503
Mailing address
4303 W 24TH AVE STE A, KENNEWICK, WA 99338-1963
(509) 585-2500
(509) 585-2503

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE 9925
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000256
WA
Enumeration date
10/30/2012
Last updated
10/30/2012
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