Individual
DR. ANISSA MONSEAU ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
703 N MAIN ST, NEW MARTINSVILLE, WV 26155-1414
(304) 455-4200
(304) 455-3823
Mailing address
15 NEUBAUER DR, NEW MARTINSVILLE, WV 26155-2869
(304) 455-4074
(304) 455-3823
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3401
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1331245
UNITED CONCORDIA
WV
05
—
4001063000
—
WV
Enumeration date
09/20/2006
Last updated
07/09/2007
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