Individual
DR. DOUGLAS M ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
2651 W SOUTH JORDAN PKWY STE 201, SOUTH JORDAN, UT 84095-8966
(801) 254-2700
(801) 253-2787
Mailing address
2651 W SOUTH JORDAN PKWY STE 201, SOUTH JORDAN, UT 84095-8966
(801) 254-2700
(801) 253-2787
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
143412-9921
UT
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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