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General NPI Number Information
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NPI Number | 1811316193
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Entity Type | Individual
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Provider Name | GRACE E ANDERSON DMD, MS
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Gender | Female
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 223 CHIEF JUSTICE CUSHING HWY STE 102
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City | COHASSET
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State | MA
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Zip | 02025-1391
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Country | US
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Telephone | 781-383-0003
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CHARLESGATE E APT 102
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City | BOSTON
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State | MA
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Zip | 02215-2368
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Country | US
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Telephone | 614-218-0015
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Fax |
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 1857530
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License Number State | MA
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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 | DN1857530
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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