Organization
ERICKSON DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY S ERICKSON DDS (DENTIST)
(515) 276-4981
Entity
Organization
Contact information
Practice address
7117 HICKMAN ROAD, URBANDALE, IA 50322-4851
(515) 276-4981
(515) 276-4864
Mailing address
7117 HICKMAN ROAD, URBANDALE, IA 50322-4851
(515) 276-4981
(515) 276-4864
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
08410
IA
122300000X
Dentist
Primary
7898
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0037333
—
IA
Enumeration date
11/30/2006
Last updated
08/22/2020
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