Provider Demographics
NPI:1831397389
Name:ANDERSON, AARON J (DDS)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:J
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 1:800 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTSMOUTH
Mailing Address - State:NE
Mailing Address - Zip Code:68048-2529
Mailing Address - Country:US
Mailing Address - Phone:402-201-8284
Mailing Address - Fax:
Practice Address - Street 1:989375 NEBRASKA MEDICAL CTR
Practice Address - Street 2:DOC 3615
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-9375
Practice Address - Country:US
Practice Address - Phone:402-559-6100
Practice Address - Fax:402-559-9607
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD0629122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist