Individual
DR. DOUGLAS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5200 S 76TH ST, GREENDALE, WI 53129-1116
(414) 423-1540
Mailing address
7216 W BELOIT RD, WEST ALLIS, WI 53219-1963
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6109
WI
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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