Eric Dale Nordstrom, DDS Valid NPI
Individual provider · Dentist · Willmar, MN
- NPI
- 1972549145
- Type
- Individual (Type 1)
- Primary specialty
- Dentist
- Specialty group
- Dental Providers
- Taxonomy code
- 122300000X
- License number
- D10397 (MN)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2006-06-22
- Last updated
- 2007-07-08
Practice location
309 Lakeland Drive Se, Suite 1
Willmar, MN 56201-4099
(320) 235-1075