Organization
ERICKSON/AAMODT ORTHODONTICS, P.A.
Active
Organization
ERICKSON/AAMODT ORTHODONTICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH ROBERT ERICKSON DDS (PRESIDENT)
(651) 426-3873
Entity
Organization
Contact information
Practice address
4790 WHITE BEAR PKWY, WHITE BEAR LAKE, MN 55110-3336
(651) 426-3873
(651) 653-5790
Mailing address
4790 WHITE BEAR PKWY, WHITE BEAR LAKE, MN 55110-3336
(651) 426-3873
(651) 653-5790
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D9558
MN
Other
Enumeration date
05/29/2008
Last updated
05/29/2008
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