Organization
RUSSELL ERICKSON DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL ERICKSON III DDS (DENTIST/OWNER)
(503) 353-1471
Entity
Organization
Contact information
Practice address
13530 SE 97TH AVE, CLACKAMAS, OR 97015-7691
(503) 353-1471
(503) 353-1473
Mailing address
13530 SE 97TH AVE, CLACKAMAS, OR 97015-7691
(503) 353-1471
(503) 353-1473
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D6120
OR
Other
Enumeration date
05/13/2008
Last updated
05/13/2008
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