Jeffrey Anderson, DDS

Individual provider Active NPI General Practice Dentistry · Folsom, CA

NPI 1326524596 · NPPES record last updated Jul 11, 2018

Key facts

NPI
1326524596
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
102607 (CA)
Practice address
2304 E Bidwell St # 100
Folsom, CA 95630-3455
Phone
(916) 983-6767
NPI assigned
Jul 11, 2018
Sex
Male
Sole proprietor
No

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
102607CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 102607 CA Yes

Addresses

Primary practice location

2304 E Bidwell St # 100
Folsom, CA 95630-3455

Mailing address

11250 Nevada St
Redlands, CA 92373-4367
Phone (661) 474-0880

Other providers in Folsom, CA

All providers in Folsom, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.