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General NPI Number Information
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NPI Number | 1699066027
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Entity Type | Individual
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Provider Name | CHRISTOPHER WESLEY ANDERSON D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2011
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Last Update Date | 02/17/2016
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Provider Practice Location Address
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Address Line | 1460 RITCHIE HWY #203
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City | ARNOLD
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State | MD
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Zip | 21012-2730
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Country | US
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Telephone | 410-757-6681
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Fax |
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Provider Business Mailing Address
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Address Line | 1460 RITCHIE HWY STE 203
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City | ARNOLD
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State | MD
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Zip | 21012-2741
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Country | US
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Telephone | 410-757-6681
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Fax | 410-757-0161
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 018.001802
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 14864
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License Number State | MD
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