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General NPI Number Information
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NPI Number | 1841372026
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Entity Type | Organization
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Legal Business Name | JOHN ARTHUR ANDERSON, P.A.
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1516 S NOVA RD
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-5816
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Country | US
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Telephone | 386-258-6964
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Fax | 386-258-9134
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Provider Business Mailing Address
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Address Line | 13759 SAXON LAKE DR
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City | JACKSONVILLE
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State | FL
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Zip | 32225-2624
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN ARTHUR ANDERSON
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Credential | DDS, MS
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Telephone | 386-258-6964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | DN9065
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License Number State | FL
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