Provider Demographics
NPI:1902994247
Name:ANDERSON, BILL J (DDS)
Entity Type:Individual
Prefix:
First Name:BILL
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 1:1401 E SANDUSKY ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-6456
Mailing Address - Country:US
Mailing Address - Phone:419-424-5850
Mailing Address - Fax:419-424-0697
Practice Address - Street 1:1401 E SANDUSKY ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-6456
Practice Address - Country:US
Practice Address - Phone:419-424-5850
Practice Address - Fax:419-424-0697
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0209151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice