| NPI | 1457772816 |
|---|---|
| Doing Business As | ANDERSON LANE DENTAL |
| Entity Type | Organization |
| Authorized Contact | GERALD BERNARD PEVOW Owner 512-459-4347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 28268) |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2014-01-02 |