Healthcare Provider Details

I. General information

NPI: 1568457877
Provider Name (Legal Business Name): DAVID ADKIN ANDERSON D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 10/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 BUTLER ST SUITE 100
PITTSBURGH PA
15201-3132
US

IV. Provider business mailing address

4201 BUTLER ST SUITE 100
PITTSBURGH PA
15201-3132
US

V. Phone/Fax

Practice location:
  • Phone: 412-687-8200
  • Fax: 412-687-8201
Mailing address:
  • Phone: 412-687-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDS022721L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: