Provider Demographics
NPI:1679911291
Name:ANDERSON, ERIN ROSE (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:ROSE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 S 13TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5767
Mailing Address - Country:US
Mailing Address - Phone:402-371-3745
Mailing Address - Fax:
Practice Address - Street 1:1105 S 13TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5767
Practice Address - Country:US
Practice Address - Phone:402-371-3745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7080122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist