Provider Demographics
NPI:1124149034
Name:DAVID A.F. ANDERSON, D.D.S., INC.
Entity type:Organization
Organization Name:DAVID A.F. ANDERSON, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:AF
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-495-8100
Mailing Address - Street 1:2645 ARAPAHO RD STE 113
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-7943
Mailing Address - Country:US
Mailing Address - Phone:972-495-8100
Mailing Address - Fax:972-495-8111
Practice Address - Street 1:2645 ARAPAHO RD STE 113
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-7943
Practice Address - Country:US
Practice Address - Phone:972-495-8100
Practice Address - Fax:972-495-8111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX 160311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID NUMBER