Louis A Erickson, DDS Valid NPI
Individual provider · General Practice Dentistry · Provo, UT
- NPI
- 1043386824
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 136096 (UT)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2006-11-25
- Last updated
- 2007-07-08
Practice location
777 N 500 W, Suite 201 B
Provo, UT 84601-1541
(801) 374-5100