Provider Demographics
NPI:1699066027
Name:ANDERSON, CHRISTOPHER WESLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WESLEY
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 RITCHIE HWY
Mailing Address - Street 2:STE 203
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2741
Mailing Address - Country:US
Mailing Address - Phone:410-757-6681
Mailing Address - Fax:410-757-0161
Practice Address - Street 1:1460 RITCHIE HWY
Practice Address - Street 2:#203
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2730
Practice Address - Country:US
Practice Address - Phone:410-757-6681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL018.001802122300000X
MD14864122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist