# DR SVEN ERICKSON D D S P C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MODERN DENTISTRY ASSOCIATES
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972872851
- **Authorized official:** DR. SVEN ALAN ERICKSON DDS (PRESIDENT)
- **Authorized official phone:** (269) 429-1515

## Contact information

- **Practice address:** 3915 STONEGATE PARK, SAINT JOSEPH, MI 49085-9130
- **Practice address phone:** (269) 429-1515
- **Practice address fax:** (269) 429-1538
- **Mailing address:** 3915 STONEGATE PARK, SAINT JOSEPH, MI 49085-9130
- **Mailing address phone:** (269) 429-1515
- **Mailing address fax:** (269) 429-1538

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901015318 | MI | Yes |
| 332BC3200X | Customized Equipment (DME) | — | NULL | — |

## Other

- **Enumeration date:** 12/21/2011
- **Last updated:** 03/20/2012