NPI 1174746697 · live from the CMS NPI Registry
Alan H. Anderson, D.D.S.
Dentist in Salt Lake City, UT. National Provider Identifier 1174746697, active.
NPI record
| NPI | 1174746697 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist 122300000X |
| Practice location | 1758 W 4805 S, Salt Lake City, UT 84118 |
| Practice phone | 801-964-6699 |
| Mailing address | 7931 Shaggy Mountain Rd, Herriman, UT 84065 |
| Enumerated | April 11, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist primary | 122300000X | 142218 (UT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.