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1528216256
IAN MATTHEW ERICKSON
GRANTS PASS, OR
NPI
1528216256
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: OR D9158)
Enumeration Date
2008-09-06
Last Update Date
2008-09-06
Business Address
Dr. IAN MATTHEW ERICKSON DMD
1224 NE 7TH ST
GRANTS PASS, OR 97526-1424
Phone number: 541-476-3419
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Mailing Address
Dr. IAN MATTHEW ERICKSON DMD
80 HASKELL ST APT 3
CENTRAL POINT, OR 97502-2395
Phone number: 971-237-0096
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