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NPI Code Detail

MEDICARE: DR. CARL ERIC ANDERSON D.D.S

MEDICARE: DR. CARL ERIC ANDERSON D.D.S
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
11223G0001XGeneral Practice Dentistry8902CT

General Provider Information

NPI Number : 1417953191
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARL ERIC ANDERSON D.D.S
Provider Business Mailing Address
First Line : 22 FLEETWOOD RD
Second Line :
City : NEWINGTON
State : CT
Zip : 06111-4405
Country : US
Telephone Number : 860-666-5590
Fax Number :
Provider Business Practice Location Address
First Line : 840 HOWARD AVE
Second Line :
City : NEW HAVEN
State : CT
Zip : 06519-1106
Country : US
Telephone Number : 203-562-5187
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 09/06/2023

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