Individual
STEVEN E ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, PA
Contact information
Practice address
311 S DIVISION AVE, SANDPOINT, ID 83864-2710
(208) 263-7597
(208) 263-8845
Mailing address
311 S DIVISION AVE, SANDPOINT, ID 83864-2710
(208) 263-7597
(208) 263-8845
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D 1970
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1970
DELTA
ID
01
—
48148
BS
ID
01
—
6253-9
BX
ID
01
—
62539
BCBS
ID
01
—
820487001
FED TAX ID
ID
01
—
D 1970
LICENSE
ID
Enumeration date
01/24/2007
Last updated
03/07/2023
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