Anderson, Edward Andrew

Anderson, Edward Andrew is an sole proprietor health care provider with primary practice located at 302 2Nd Ave Sw , Jamestown ND 58401-4157. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Anderson, Edward Andrew can be contacted via phone (701) 252-1661.

Contact Information

Primary practice address
302 2Nd Ave Sw Jamestown ND 58401-4157
Fax: (701) 251-9128
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 1559 North Dakota

Profile Details

NPI number 1699886457
LBN Legal business name Anderson, Edward Andrew
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 31st, 2006
Last updated Jul 9th, 2007 - about 19 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 1699886457 NPPES
North Dakota Other 1559 STATE LICENSE #
North Dakota MEDICAID 40612 STATE LICENSE #

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