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Individual

DR. ERIC JUSTIN SORENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
762 14TH ST, ELKO, NV 89801-3413
(775) 738-1553
(775) 738-5934
Mailing address
762 14TH ST, ELKO, NV 89801-3413
(775) 738-1553
(775) 738-5934

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
24285
TX
122300000X
Dentist
325161
UT
122300000X
Dentist
Primary
4792
NV
1223G0001X
General Practice Dentistry
4792
NV
1223G0001X
General Practice Dentistry
6542
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100510329
NV
05
1346337714
NV
Enumeration date
10/06/2006
Last updated
08/28/2012
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