| Organization Name: | WILLIAM R ANDERSON DMD PSC |
| NPI Number: | 1295861524 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM R ANDERSON (PRESIDENT) |
| Mailing Address: | 972 Broadway Plaza Paintsville |
| State: | KY US |
| Postal Code: | 41240 |
| Phone Number: | 6067891912 |
| Fax Number: | 6067891939 |
| NPI Enumeration Date: | 02/23/2007 |
| NPI Last Update Date: | 03/12/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | 5386 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |