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General NPI Number Information
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NPI Number | 1750896031
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Entity Type | Organization
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Legal Business Name | DONALD S. ANDERSON, D.D.S., INC.
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Dates
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Enumeration Date | 12/07/2017
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 7789 N. INGRAM AVENUE SUITE 101
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City | FRESNO
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State | CA
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Zip | 93711
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Country | US
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Telephone | 559-222-3300
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Fax | 559-222-3332
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Provider Business Mailing Address
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Address Line | 7789 N. INGRAM AVENUE SUITE 101
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City | FRESNO
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State | CA
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Zip | 93711
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Country | US
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Telephone | 559-222-3300
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Fax | 559-222-3332
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Authorized Official
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Title or Position | CEO/PRESIDENT/DENTIST
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Name | DR. DONALD STUART ANDERSON
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Credential | D.D.S.
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Telephone | 559-222-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 45426
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License Number State | CA
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