MEDICARE: DR. ARNOLD LANCE ANDERSON DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	31014	CA

General Provider Information

NPI Number	:	1306177936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARNOLD LANCE ANDERSON DDS

Provider Business Mailing Address
First Line	:	3620 CLAREMORE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-3105
Country	:	US
Telephone Number	:	562-430-1791
Fax Number	:

Provider Business Practice Location Address
First Line	:	3490 LINDEN AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-4559
Country	:	US
Telephone Number	:	562-426-6948
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2010
Last Update Date	:	01/21/2010

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