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NPI Code Detail

MEDICARE: ROSS W. ANDERSON, DDS, PA

MEDICARE: ROSS W. ANDERSON, DDS, PA
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1891093084
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROSS W. ANDERSON, DDS, PA
Provider Business Mailing Address
First Line : 1106 N MECHANIC ST
Second Line :
City : EL CAMPO
State : TX
Zip : 77437-3030
Country : US
Telephone Number : 979-543-4291
Fax Number : 979-543-8482
Provider Business Practice Location Address
First Line : 1106 N MECHANIC ST
Second Line :
City : EL CAMPO
State : TX
Zip : 77437-3030
Country : US
Telephone Number : 979-543-4291
Fax Number : 979-543-8482
Authorized Official
Title or Position : PRESIDENT
Name : DR. ROSS WYATT ANDERSON
Credential : DDS
Telephone Number : 979-543-4291
Provider Enumeration Date : 03/11/2011
Last Update Date : 03/11/2011

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