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Individual
DR. ERIC DRIVER
Active
Individual
DR. ERIC DRIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
59069
CA
1223G0001X
General Practice Dentistry
2004017842
MO
1223P0300X
Periodontics
Primary
59069
CA
Other
Enumeration date
09/23/2005
Last updated
01/28/2010
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