Individual
BRAD W ERICKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11110 FORT ST, OMAHA, NE 68164-2183
(402) 492-8300
Mailing address
123 N 31ST AVE, OMAHA, NE 68131-2912
(208) 914-0971
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7839
NE
1223G0001X
General Practice Dentistry
DDS-10006
IA
Other
Enumeration date
06/20/2022
Last updated
03/14/2024
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