Anderson, Devren Clay
Anderson, Devren Clay is an individual health care provider with primary practice located at 6104 S Lyncrest Ave , Sioux Falls SD 57108-2560. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Anderson, Devren Clay can be contacted via phone (605) 274-6191.Contact Information
Primary practice address
6104 S Lyncrest Ave
Sioux Falls SD 57108-2560
Phone: (605) 274-6191
Fax: (605) 274-6192
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D0918 | South Dakota |
Profile Details
| NPI number | 1063575629 |
|---|---|
| LBN Legal business name | Anderson, Devren Clay |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 18th, 2006 |
| Last updated | Aug 30th, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063575629 | NPPES |
| Minnesota | MEDICAID | 490632200 |
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