Provider Demographics
NPI:1417142498
Name:ANDERSON, DENNIS E (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:E
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:997 JOHNNIE DODDS BLVD
Mailing Address - Street 2:# 1017
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-6132
Mailing Address - Country:US
Mailing Address - Phone:843-568-2321
Mailing Address - Fax:
Practice Address - Street 1:997 JOHNNIE DODDS BLVD
Practice Address - Street 2:# 1017
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-6132
Practice Address - Country:US
Practice Address - Phone:843-568-2321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2880111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor