Individual
JEFFREY TODD ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2601 E ROOSEVELT ST, PHOENIX, AZ 85008-4973
(602) 344-5011
Mailing address
PO BOX 5177, PHOENIX, AZ 85010-5177
(602) 344-5651
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4441
AZ
1223G0001X
General Practice Dentistry
Primary
24362
TX
Other
Enumeration date
11/21/2005
Last updated
07/07/2021
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