Individual
MS. ERIKA ENRIQUEZ HAYCRAFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.T.
Contact information
Practice address
1670 BEAM AVE STE 204, MAPLEWOOD, MN 55109-1227
(651) 925-8400
Mailing address
1670 BEAM AVE STE 204, MAPLEWOOD, MN 55109-1227
(651) 925-8400
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT86
MN
Other
Enumeration date
05/11/2017
Last updated
03/17/2018
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