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NPI Code Detail

MEDICARE: DR. WILLIAM STANLEY ANDERSON D.D.S.

MEDICARE: DR. WILLIAM STANLEY ANDERSON D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist12009651IN

General Provider Information

NPI Number : 1093025785
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM STANLEY ANDERSON D.D.S.
Provider Business Mailing Address
First Line : 2602 VALLEY DR
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-2511
Country : US
Telephone Number : 219-962-8586
Fax Number : 219-242-8305
Provider Business Practice Location Address
First Line : 2602 VALLEY DR
Second Line :
City : VALPARAISO
State : IN
Zip : 46383-2511
Country : US
Telephone Number : 219-962-8586
Fax Number : 219-242-8305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2010
Last Update Date : 10/14/2010

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