Individual
DR. LEA ELLA ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MSPH
Contact information
Practice address
VASLCHCS (160), 500 FOOTHILL, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
(801) 584-1251
Mailing address
7165 S 2780 E, SALT LAKE CITY, UT 84121-4152
(801) 943-0954
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
139261-9923
UT
Other
Enumeration date
08/07/2006
Last updated
07/08/2007
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