| Anderson Dental | |
|
2525 W Carefree Hwy Ste 108 Phoenix AZ 85085-6095 | |
| (623) 455-9179 | |
| Not Available |
| Full Name | Anderson Dental |
|---|---|
| Speciality | Dentist |
| Location | 2525 W Carefree Hwy Ste 108, Phoenix, Arizona |
| Authorized Official Name and Position | Lori K Anderson (DOCTOR) |
| Authorized Official Contact | 6234559179 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anderson Dental 2525 W Carefree Hwy Ste 108 Phoenix AZ 85085-6095 Ph: (623) 455-9179 | Anderson Dental 2525 W Carefree Hwy Ste 108 Phoenix AZ 85085-6095 Ph: (623) 455-9179 |
| NPI Number | 1679352009 |
|---|---|
| Provider Enumeration Date | 09/25/2023 |
| Last Update Date | 09/25/2023 |
| Medicare PECOS PAC ID | 7113372848 |
|---|---|
| Medicare Enrollment ID | O20231016001314 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679352009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| Provider Name | Lori K Anderson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1326024506 PECOS PAC ID: 0749693760 Enrollment ID: I20210113000818 |
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