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General NPI Number Information
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NPI Number | 1619952314
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Entity Type | Individual
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Provider Name | JAMES GREGORY ANDERSON DDS
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Gender | Male
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 175 FRANK PRICE BLVD
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City | CLINTON
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State | TN
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Zip | 37716-1420
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Country | US
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Telephone | 865-622-4959
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Fax | 865-269-4336
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Provider Business Mailing Address
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Address Line | 175 FRANK PRICE BLVD
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City | CLINTON
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State | TN
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Zip | 37716-1420
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Country | US
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Telephone | 865-622-4959
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Fax | 865-269-4336
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS5390
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS0000005390
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License Number State | TN
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