Individual
DAESHA N ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
503 14TH AVE, FAIRBANKS, AK 99701-6236
(907) 374-3889
Mailing address
503 14TH AVE, FAIRBANKS, AK 99701-6236
(907) 374-3889
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
110367
AK
122300000X
Dentist
60652740
WA
Other
Enumeration date
07/21/2016
Last updated
07/21/2022
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