Susan K Anderson, DMD

Individual provider Active NPI General Practice Dentistry · Duluth, GA

NPI 1962555151 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1962555151
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
10853 (GA)
Practice address
2925 Premiere Parkway
Suite 165
Duluth, GA 30097
Phone
(678) 417-9656
NPI assigned
Jan 19, 2007
Sex
Female
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

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson and Anderson DMD PC General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10853 GA Yes

Addresses

Primary practice location

2925 Premiere Parkway
Suite 165
Duluth, GA 30097

Mailing address

2925 Premiere Parkway
Suite 165
Duluth, GA 30097
Phone (678) 417-9656

Other providers in Duluth, GA

All providers in Duluth, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.