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DR. RUSSELL ANDERS D.D.S.

>> Dentist >> Dental Providers

Registrant NPI Number: 1043555915

Individual Registrant:
DR. RUSSELL  ANDERS D.D.S.
Gender: M
Sole Proprietor

Location and contact information for practice:
2481 TANAGER LN  CAMINO, CA 95709-9738 US
Tel: 530-644-3438  Fax: 530-644-3438

Contact information for business:
2481 TANAGER LN  CAMINO, CA 95709-9738 US
Tel: 530-644-3438  Fax: 530-644-3438

Registration Information:
NPI: 1043555915
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
CA18445

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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