Individual
DR. MATTHEW RYAN ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
199 N 9TH ST, COOS BAY, OR 97420-1702
(541) 267-4314
Mailing address
199 N 9TH ST, COOS BAY, OR 97420-1702
(541) 267-4314
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10472
OR
Other
Enumeration date
07/05/2016
Last updated
07/05/2016
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