Individual
DR. LARRY DOUGLAS ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, ABGD
Contact information
Practice address
11736 IMPRESSIVE VIEW DRIVE, DEADWOOD, SD 57732-0154
(605) 578-7519
(605) 578-7519
Mailing address
PO BOX 154, DEADWOOD, SD 57732-0154
(605) 578-7519
(605) 578-7519
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
29012
CA
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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