| Robert E. Anderson, Dds, Pa | |
|
1 Saint Vincent Cir Ste 240 Little Rock AR 72205-5407 | |
| (501) 664-3900 | |
| (501) 663-6076 |
| Full Name | Robert E. Anderson, Dds, Pa |
|---|---|
| Speciality | Dentist |
| Location | 1 Saint Vincent Cir Ste 240, Little Rock, Arkansas |
| Authorized Official Name and Position | Robert E Anderson (ORAL & MAXILLOFACIAL SURGEON) |
| Authorized Official Contact | 5016643900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert E. Anderson, Dds, Pa 1 Saint Vincent Cir Ste 240 Little Rock AR 72205-5407 Ph: (501) 664-3900 | Robert E. Anderson, Dds, Pa 1 Saint Vincent Cir Ste 240 Little Rock AR 72205-5407 Ph: (501) 664-3900 |
| NPI Number | 1003052234 |
|---|---|
| Provider Enumeration Date | 12/17/2008 |
| Last Update Date | 04/29/2011 |
| Medicare PECOS PAC ID | 7517142938 |
|---|---|
| Medicare Enrollment ID | O20110429000150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003052234 | NPI | - | NPPES |
| 127328679 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 1729 (Arkansas) | Primary |
| Provider Name | Bob Anderson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1780690065 PECOS PAC ID: 4486839891 Enrollment ID: I20110429000088 |
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