Organization
I SMILE AT VIP DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VERD ERICKSON DDS (DENTIST)
(435) 673-3211
Entity
Organization
Contact information
Practice address
330 E TABERNACLE ST, SUITE #1, ST GEORGE, UT 84770-3093
(435) 673-3211
Mailing address
330 E TABERNACLE ST, SUITE #1, ST GEORGE, UT 84770-3093
(435) 673-3211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
133468-8903
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
520387276
—
UT
Enumeration date
07/29/2014
Last updated
07/29/2014
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