Individual
NATHAN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1395 N 400 E, LOGAN, UT 84341-7530
(435) 755-5000
Mailing address
1395 N 400 E STE B, LOGAN, UT 84341-7531
(435) 755-5000
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
14206222-9926
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/25/2021
Last updated
06/09/2025
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