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Organization

DR SVEN ERICKSON D D S P C

Active
Other names
MODERN DENTISTRY ASSOCIATES
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SVEN ALAN ERICKSON DDS (PRESIDENT)
(269) 429-1515
Entity
Organization

Contact information

Practice address
3915 STONEGATE PARK, SAINT JOSEPH, MI 49085-9130
(269) 429-1515
(269) 429-1538
Mailing address
3915 STONEGATE PARK, SAINT JOSEPH, MI 49085-9130
(269) 429-1515
(269) 429-1538

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901015318
MI
332BC3200X
Customized Equipment (DME)

Other

Enumeration date
12/21/2011
Last updated
03/20/2012
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