Individual
SHAWN R ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
25109 JEFFERSON AVE, #220, MURRIETA, CA 92562-8116
(951) 514-7377
Mailing address
46254 DURANGO DR, TEMECULA, CA 92592-4232
(951) 514-7377
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
57725
CA
1223E0200X
Endodontics
Primary
D008275
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100509660
—
NV
Enumeration date
07/21/2006
Last updated
05/12/2014
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