Organization
ERICKSON DMD PC
Active
Organization
ERICKSON DMD PC
Active
Other names
307 Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KOLTON K ERICKSON D.M.D. (PRESIDENT)
(307) 237-8419
Entity
Organization
Contact information
Practice address
932 S DAVID ST, CASPER, WY 82601-3738
(307) 237-8419
(307) 234-4912
Mailing address
PO BOX 2190, CASPER, WY 82602-2190
(307) 237-8419
(307) 234-4912
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1329
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770893414
NPI
WY
Enumeration date
08/01/2013
Last updated
08/01/2013
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