Wendell Gross Anderson, DMD

Individual provider Active NPI General Practice Dentistry · Wareham, MA

NPI 1144484171 · NPPES record last updated Jul 18, 2008

Key facts

NPI
1144484171
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
14481 (MA)
Practice address
152 High St
Wareham, MA 02571
Phone
(508) 295-2111
Fax
(508) 295-5186
NPI assigned
Jul 18, 2008
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
14481MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Dental Assoc of Wareham General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 14481 MA Yes

Addresses

Primary practice location

152 High St
Wareham, MA 02571

Mailing address

152 High St
Gateway Dental Assoc of Wareham
Wareham, MA 02571
Phone (508) 295-2111

Other providers in Wareham, MA

All providers in Wareham, MA · General Practice Dentistry in Massachusetts

Sources for this page

Verify at the official NPI Registry.