| NPI | 1215278676 |
|---|---|
| Former Legal Business Name | ANDERSON DENTAL LLC |
| Entity Type | Organization |
| Authorized Contact | BRADLEY JON ANDERSON Co Owner 701-232-1368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ND ND2045) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: ND ND1601) |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2020-09-25 |