Individual
JON ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
23 S COUNTY ROAD 200 EAST, STE B, DANVILLE, IN 46122
(317) 745-4400
Mailing address
PO BOX 486, DANVILLE, IN 46122-0486
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010220
IN
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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