Organization
NORTH LAKE FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATTY R ERICKSON DDS (OWNER)
(262) 966-7668
Entity
Organization
Contact information
Practice address
W315N7641 HWY 83, HARTLAND, WI 53029-9759
(262) 966-7668
Mailing address
W315N7641 HWY 83, HARTLAND, WI 53029-9759
(262) 966-7668
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
6346
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982723920
NPI
WI
Enumeration date
12/05/2014
Last updated
12/05/2014
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