| Organization Name: | GREG A. ANDERSON, DDS,PC |
| NPI Number: | 1093171977 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GREGORY A. ANDERSON (PRESIDENT) |
| Mailing Address: | 501 Main St Suite 4 Williston |
| State: | ND US |
| Postal Code: | 588015327 |
| Phone Number: | 7015772261 |
| Fax Number: | 7015770737 |
| NPI Enumeration Date: | 01/08/2016 |
| NPI Last Update Date: | 01/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |