| Russell Erickson Dds Pc | |
|
13530 Se 97th Ave Clackamas OR 97015-7691 | |
| (503) 353-1471 | |
| (503) 353-1473 |
| Full Name | Russell Erickson Dds Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 13530 Se 97th Ave, Clackamas, Oregon |
| Authorized Official Name and Position | Russell Erickson (DENTIST/OWNER) |
| Authorized Official Contact | 5033531471 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell Erickson Dds Pc 13530 Se 97th Ave Clackamas OR 97015-7691 Ph: (503) 353-1471 | Russell Erickson Dds Pc 13530 Se 97th Ave Clackamas OR 97015-7691 Ph: (503) 353-1471 |
| NPI Number | 1497922041 |
|---|---|
| Provider Enumeration Date | 05/13/2008 |
| Last Update Date | 05/13/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497922041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D6120 (Oregon) | Primary |
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