Individual
DR. JEFFREY DAVIS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5754 ANTIOCH RD, MERRIAM, KS 66202-2015
(913) 671-7066
Mailing address
5601 HOLMES ST, KANSAS CITY, MO 64110-2727
(816) 810-2453
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2015000298
MO
122300000X
Dentist
Primary
61140
KS
122300000X
Dentist
D9859
OR
Other
Enumeration date
05/30/2013
Last updated
04/07/2015
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