Organization
ERICKSON/AAMODT ORTHODONTICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH ROBERT ERICKSON DDS (PRESIDENT)
(651) 405-1055
Entity
Organization
Contact information
Practice address
2130 CLIFF RD, SUITE 220, EAGAN, MN 55122-2485
(651) 405-1055
(651) 405-0727
Mailing address
2130 CLIFF RD, SUITE 220, EAGAN, MN 55122-2485
(651) 405-1055
(651) 405-0727
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D9558
MN
Other
Enumeration date
05/30/2008
Last updated
05/30/2008
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