Anderson, David M

Anderson, David M is an individual health care provider with primary practice located at 4660 W College Ave , Appleton WI 54913-8507. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Anderson, David M can be contacted via phone (920) 730-0345.

Contact Information

Primary practice address
4660 W College Ave Appleton WI 54913-8507
Phone: (920) 730-0345
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 315501-9924 Utah
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 315501-1205 Utah
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 1002515 Wisconsin

Profile Details

NPI number 1619061546
LBN Legal business name Anderson, David M
Credentials DDS, MD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Nov 24th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619061546 NPPES
Utah Other 870679577 TAX-ID

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