Organization
ANDERSON DENTAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ANDERSON DDS (PRESIDENT)
(443) 812-0856
Entity
Organization
Contact information
Practice address
5036 DORSEY HALL DR STE 105, ELLICOTT CITY, MD 21042-7890
(410) 992-1980
Mailing address
6504 EVENING SHADOWS CT, CLARKSVILLE, MD 21029-1543
(443) 812-0856
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14135
GENERAL DENTIST
MD
Enumeration date
10/22/2021
Last updated
10/22/2021
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