Individual
DR. LORI ANDERSON AIOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1530 BUSINESS CENTER DR, SUITE 2, ORANGE PARK, FL 32003-9026
(904) 215-0980
(904) 215-0952
Mailing address
1894 OSPREY BLUFF BLVD, ORANGE PARK, FL 32003-7937
(904) 215-1866
(904) 215-0952
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN0013020
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN0013020
LICENSE NUMBER
FL
Enumeration date
11/30/2006
Last updated
07/08/2007
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