Provider Demographics
NPI:1982743670
Name:ANDERSON, MARGARET JO (CDA, EFDA)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:JO
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CDA, EFDA
Other - Prefix:MS
Other - First Name:MAGGIE
Other - Middle Name:JO
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CDA,EFDA
Mailing Address - Street 1:12711 SE MILLPLAIN DR.
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6054
Mailing Address - Country:US
Mailing Address - Phone:360-896-4484
Mailing Address - Fax:360-896-4489
Practice Address - Street 1:12711 SE MILL PLAIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6053
Practice Address - Country:US
Practice Address - Phone:360-896-4484
Practice Address - Fax:360-896-4489
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant