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Organization
ERICSON DENTAL GROUP-LOMPOC
Active
Organization
ERICSON DENTAL GROUP-LOMPOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEN M ERICSON DDS (OWNER)
(805) 735-2702
Entity
Organization
Contact information
Practice address
1201 E OCEAN AVE, STE. G, LOMPOC, CA 93436-7081
(805) 735-2702
Mailing address
1201 E OCEAN AVE, STE. G, LOMPOC, CA 93436-7081
(805) 735-2702
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/30/2016
Last updated
06/30/2016
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