Organization
ERICSON DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEN ERICSON DDS (OWNER)
(805) 708-7866
Entity
Organization
Contact information
Practice address
1201 E OCEAN AVE STE G, LOMPOC, CA 93436-7083
(805) 735-2702
Mailing address
1201 E OCEAN AVE STE G, LOMPOC, CA 93436-7083
(805) 735-2702
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
57188
CA
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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