Individual
LESLIE ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4533 BANCROFT ST, OMAHA, NE 68106-3332
(701) 640-1151
Mailing address
4533 BANCROFT ST, OMAHA, NE 68106-3332
(701) 640-1151
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10151
IA
122300000X
Dentist
Primary
7958
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2023
Last updated
09/11/2023
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