Jon D Anderson, DDS
Dentist, General Practice in Fargo, ND. Individual provider (NPI-1).
NPI number1669554341
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1669554341
- Entity type
- Individual (NPI-1)
- Name
- Jon D Anderson
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 20, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 1601 | ND | Yes |
Practice location
2538 University Dr SSte B
Fargo, ND 58103-5737
Phone 701-232-1368 · Fax 701-232-4746
Mailing address
2538 University Dr SSte B
Fargo, ND 58103-5737
Phone 701-232-1368 · Fax 701-232-4746
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