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RYAN TAYLOR ANDERSON D.D.S

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1083086524

Individual Registrant:
 RYAN TAYLOR ANDERSON D.D.S
Gender: M
Sole Proprietor

Location and contact information for practice:
13 EAST 4TH STREET  LA JUNTA, CO 81050 US
Tel: 719-384-9442  Fax: 719-384-9446

Contact information for business:
13 EAST 4TH STREET  LA JUNTA, CO 81050 US
Tel: 719-384-9442  Fax: 719-384-9446

Registration Information:
NPI: 1083086524
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
CO00202659

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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