Basic Information
| Provider Information | |||||||||
| NPI: | 1124149034 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DAVID A.F. ANDERSON, D.D.S., INC. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2645 ARAPAHO RD STE 113 | ||||||||
| Address2: | |||||||||
| City: | GARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750447943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724958100 | ||||||||
| FaxNumber: | 9724958111 | ||||||||
| Practice Location | |||||||||
| Address1: | 2645 ARAPAHO RD STE 113 | ||||||||
| Address2: | |||||||||
| City: | GARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750447943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724958100 | ||||||||
| FaxNumber: | 9724958111 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2007 | ||||||||
| LastUpdateDate: | 04/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | ANDERSON | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | A.F. | ||||||||
| AuthorizedOfficialTitleorPosition: | DENTIST | ||||||||
| AuthorizedOfficialTelephone: | 9724958100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | D.D.S | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | TX 16031 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Dental Providers | Dentist | General Practice |
No ID Information.