Mart D Erickson Dds Pc

NPI 1164414470 - Dentist - 1223G0001X

NPI Details
NPI 1164414470
Enumeration Date 08/22/2005
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name MARY D MARY
Position PRESIDENT DENTIST
Phone (541) 476-3419
Fax (541) 476-6985
Practice Location
1224 NE 7TH ST
GRANTS PASS OR, 97526, US
Phone (541) 476-3419
Fax (541) 476-6985
Business Location
1224 NE 7TH ST
GRANTS PASS OR, 97526, US
Phone (541) 476-3419
Fax (541) 476-6985
Toxanomy
Taxonomy Code 1223G0001X
License State Oregon
License Number 5491
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According to our database, Mart D Erickson Dds Pc NPI is 1164414470, taxonomy code is 1223G0001X and license number is 5491, license state is located at Oregon. Mart D Erickson Dds Pc physically located at 1224 Ne 7th St, Grants Pass OR, 97526. NPI Number 1033115704 has the healthcare provider type.

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1164414470 NPI number is provided on an as is basis without warranty of any kind. 1164414470 is maintained by the National Plan & Provider Enumeration System. The contents of Mart D Erickson Dds Pc are for informational purposes only.