Organization
ERICKSON ORAL & MAXILLOFACIAL SURGERY, LLC
Active
Other names
Prairie Path Oral Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK F ERICKSON DDS (OWNER/SURGEON)
(630) 308-9902
Entity
Organization
Contact information
Practice address
383 S SCHMALE RD, CAROL STREAM, IL 60188-2756
(630) 909-0500
Mailing address
383 S SCHMALE RD, CAROL STREAM, IL 60188-2756
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/28/2024
Last updated
02/28/2024
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