| NPI | 1215794060 |
|---|---|
| Doing Business As | PRAIRIE PATH ORAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | MARK F ERICKSON Owner/Surgeon 630-308-9902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2024-02-28 |
| Last Update Date | 2024-02-28 |