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General NPI Number Information
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NPI Number | 1134265655
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Entity Type | Organization
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Legal Business Name | MORGAN L ANDERSEN, DDS, PS
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/15/2011
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Provider Practice Location Address
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Address Line | 12116 SE MILL PLAIN BLVD
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City | VANCOUVER
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State | WA
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Zip | 98684-6000
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Country | US
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Telephone | 360-256-8200
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Fax | 360-256-9356
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Provider Business Mailing Address
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Address Line | 12116 SE MILL PLAIN BLVD
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City | VANCOUVER
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State | WA
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Zip | 98684-6000
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Country | US
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Telephone | 360-256-8200
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Fax | 360-256-9356
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Authorized Official
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Title or Position | PATIENT SPECIALIST
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Name | MS. KENDRA SHANK
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Credential |
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Telephone | 360-256-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6032
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License Number State | WA
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