MEDICARE: CHRISTOPHER W ANDERSON DDS LLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1326515388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTOPHER W ANDERSON DDS LLC

Provider Business Mailing Address
First Line	:	8 MORRIS ST
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-2816
Country	:	US
Telephone Number	:	443-852-1222
Fax Number	:

Provider Business Practice Location Address
First Line	:	914 BAY RIDGE RD STE 110
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21403-3935
Country	:	US
Telephone Number	:	410-267-7713
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHRISTOPHER WESLEY ANDERSON
Credential	:	DDS
Telephone Number	:	443-852-1222

Provider Enumeration Date	:	10/29/2018
Last Update Date	:	10/29/2018

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