MEDICARE: DR. STEVE F ANDERSON DDS

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
1	1223G0001X	General Practice Dentistry	3935	NE

General Provider Information

NPI Number	:	1225032501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVE F ANDERSON DDS

Provider Business Mailing Address
First Line	:	908 N HOWARD AVE
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68803-3556
Country	:	US
Telephone Number	:	308-384-0360
Fax Number	:

Provider Business Practice Location Address
First Line	:	908 N HOWARD AVE
Second Line	:
City	:	GRAND ISLAND
State	:	NE
Zip	:	68803-3556
Country	:	US
Telephone Number	:	308-384-0360
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	07/08/2007

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