Individual
DR. GARY C ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2500 COMO AVENUE - MS 31100A, HEALTH PARTNERS COMO CLINIC, ST PAUL, MN 55108-1460
(651) 641-6200
(651) 641-6205
Mailing address
8170 33RD AVE S, MS21110Q, MINNEAPOLIS, MN 55425-4516
(952) 883-5375
(651) 641-6205
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8992
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165320200
—
MN
Enumeration date
09/28/2006
Last updated
12/15/2011
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