Most Relevant Information
Provider Data
| NPI Number: | 1003502477 |
| Provider Name: | ERIC A ANDERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 122400000X |
| Specialty: | Denturist |
| License Number: | DT-DO-10180589 |
Most Important Dates
| Enumeration Date: | 04/17/2023 |
| Last Updated: | 04/17/2023 |
Provider Practice Location
156 SOUTHPORT DR
SOMERSET
KY
425014149
Practice Location Phone/Fax
| Phone: | 6066771459 |
| Fax: |
Provider Mailing Location
156 SOUTHPORT DR
SOMERSET
KY
425014149
Provider Mailing Phone/Fax
| Phone: | 6066771459 |
| Fax: |