Provider Demographics
NPI:1891924536
Name:ANDERSON, DANIEL L (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:L
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8912 TOWN AND COUNTRY CIR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4900
Mailing Address - Country:US
Mailing Address - Phone:865-531-0300
Mailing Address - Fax:
Practice Address - Street 1:8912 TOWN AND COUNTRY CIR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4900
Practice Address - Country:US
Practice Address - Phone:865-691-0995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3828122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist