| Ericson Dental Inc | |
|
1201 E Ocean Ave Ste G Lompoc CA 93436-7083 | |
| (805) 735-2702 | |
| Not Available |
| Full Name | Ericson Dental Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1201 E Ocean Ave Ste G, Lompoc, California |
| Authorized Official Name and Position | Sten Ericson (OWNER) |
| Authorized Official Contact | 8057087866 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ericson Dental Inc 1201 E Ocean Ave Ste G Lompoc CA 93436-7083 Ph: (805) 735-2702 | Ericson Dental Inc 1201 E Ocean Ave Ste G Lompoc CA 93436-7083 Ph: (805) 735-2702 |
| NPI Number | 1780175307 |
|---|---|
| Provider Enumeration Date | 05/21/2018 |
| Last Update Date | 05/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780175307 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 57188 (California) | Primary |
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