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Individual

DR. AMMON L ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
2910 HAMILTON BLVD, SUITE 101, SIOUX CITY, IA 51104-2423
(712) 255-8017
Mailing address
2910 HAMILTON BLVD, SUITE 101, SIOUX CITY, IA 51104-2423
(712) 255-8017

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
1127
WY
122300000X
Dentist
6543
NE
1223E0200X
Endodontics
Primary
08617
IA

Other

Enumeration date
05/29/2009
Last updated
05/29/2009
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