Anderson Dental, Llc | |
514-d East Woodrow Wilson Dr. Jackson MS 39216-4538 | |
(601) 366-1112 | |
(601) 366-6092 |
Full Name | Anderson Dental, Llc |
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Speciality | Dentist - General Practice |
Location | 514-d East Woodrow Wilson Dr., Jackson, Mississippi |
Authorized Official Name and Position | Leon Anderson (OWNER) |
Authorized Official Contact | 6013661112 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Anderson Dental, Llc P.o. Box 11277 Jackson MS 39283-1277 Ph: (601) 366-1112 | Anderson Dental, Llc 514-d East Woodrow Wilson Dr. Jackson MS 39216-4538 Ph: (601) 366-1112 |
NPI Number | 1013033851 |
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Provider Enumeration Date | 03/22/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013033851 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | MS2164-85 (Mississippi) | Primary |
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