Provider Demographics
NPI:1487436531
Name:THOMAS L ANDERSON, DDS INC
Entity type:Organization
Organization Name:THOMAS L ANDERSON, DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOLTHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-520-8666
Mailing Address - Street 1:4911 S ARROWHEAD DR STE 300
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-7018
Mailing Address - Country:US
Mailing Address - Phone:816-373-4440
Mailing Address - Fax:816-795-6732
Practice Address - Street 1:4911 S ARROWHEAD DR STE 300
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-7018
Practice Address - Country:US
Practice Address - Phone:816-373-4440
Practice Address - Fax:816-795-6732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental