Anderson, Robert Larry

Anderson, Robert Larry is an sole proprietor health care provider with primary practice located at 526 W Mullan Ave , Waterloo IA 50701-1544. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Anderson, Robert Larry can be contacted via phone (319) 234-2775.

Contact Information

Primary practice address
526 W Mullan Ave Waterloo IA 50701-1544
Phone: (319) 234-2775
Fax: (319) 236-1748
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 5606BJ-0006 Iowa

Profile Details

NPI number 1205842192
LBN Legal business name Anderson, Robert Larry
Credentials D.D.D.,P.C.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 31st, 2006
Last updated Jul 8th, 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 1205842192 NPPES
Iowa MEDICAID 0108811

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