Individual
DR. MARVIN PAUL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
US ARMY DENTAL ACTIVITY, 10205 N RIVA RIDGE LOOP, FORT DRUM, NY 13602-5005
(315) 772-4342
(315) 772-9692
Mailing address
US ARMY DENTAL ACTIVITY, 10205 N RIVA RIDGE LOOP, FORT DRUM, NY 13602-5005
(315) 772-4342
(315) 772-9692
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN 13813
FL
Other
Enumeration date
12/13/2005
Last updated
07/08/2007
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