MEDICARE: DR. WILLIAM T. ANDERSON D.M.D., M.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
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	6707	FL

General Provider Information

NPI Number	:	1548280589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM T. ANDERSON D.M.D., M.S.

Provider Business Mailing Address
First Line	:	3150 S CONWAY RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-7331
Country	:	US
Telephone Number	:	407-658-0280
Fax Number	:	407-658-4080

Provider Business Practice Location Address
First Line	:	3150 S CONWAY RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32812-7331
Country	:	US
Telephone Number	:	407-658-0280
Fax Number	:	407-658-4080

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	07/08/2007

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