Organization
VIRGINIA/GILBERT FAMILY DENTAL
Active
Parent organization
VIRGINIA/GILBERT FAMILY DENTAL
Other names
Erickson Holbeck Zupancic Dental/Gilbert Dental Service P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
VIRGINIA/GILBERT FAMILY DENTAL
Authorized official
DR. MARK A. ERICKSON DDS (PRESIDENT)
(218) 741-5357
Entity
Organization
Contact information
Practice address
12 NORTH BROADWAY, GILBERT, MN 55741
(218) 741-5357
(218) 741-5455
Mailing address
P.O. BOX 608, VIRGINIA/GILBERT FAMILY DENTAL, GILBERT, MN 55741
(218) 741-5357
(218) 741-5455
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10580600700
STATE OF MINNESOTA
—
Enumeration date
11/11/2009
Last updated
11/11/2009
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