Individual
STEPHEN L ERICKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
895 N 900 E, AMERICAN FORK, UT 84003-9183
(801) 763-4164
Mailing address
895 N 900 E, AMERICAN FORK, UT 84003-9183
(801) 763-4164
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5314850-9922
UT
122300000X
Dentist
DEND1161
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1161
LICENSED DENTIST
AK
01
—
5314850-9922
LICENSED DENTIST
UT
05
—
DD5568
—
AK
Enumeration date
10/19/2006
Last updated
05/24/2023
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