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NPI Code Detail

MEDICARE: DR. SCOTT MITCHELL ANDERSON D.D.S.

MEDICARE:  DR. SCOTT MITCHELL 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 Dentistry08748IA

General Provider Information

NPI Number : 1770897910
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT MITCHELL ANDERSON D.D.S.
Provider Business Mailing Address
First Line : 855 A AVE NE STE LL1
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-5064
Country : US
Telephone Number : 319-369-7730
Fax Number : 319-369-7192
Provider Business Practice Location Address
First Line : 855 A AVE NE STE LL1
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-5064
Country : US
Telephone Number : 319-369-7730
Fax Number : 319-369-7192
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2010
Last Update Date : 08/22/2014

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Directions to “ DR. SCOTT MITCHELL ANDERSON D.D.S.” Practice Location

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