Individual
JEFF L ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
508 S. 52ND STREET, ROGERS, AR 72758
(479) 845-1191
(479) 845-2155
Mailing address
508 S. 52ND STREET, ROGERS, AR 72758
(479) 845-1191
(479) 845-2155
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2792
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59288
ARKANSAS BCBS
AR
Enumeration date
12/08/2006
Last updated
07/08/2007
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