Provider Demographics
NPI:1538183983
Name:ERICKSON, DANIEL JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAMES
Last Name:ERICKSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2233 WILLAMETTE ST
Mailing Address - Street 2:BLDG E
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2890
Mailing Address - Country:US
Mailing Address - Phone:541-484-9018
Mailing Address - Fax:541-345-8037
Practice Address - Street 1:2233 WILLAMETTE ST
Practice Address - Street 2:BLDG E
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2890
Practice Address - Country:US
Practice Address - Phone:541-484-9018
Practice Address - Fax:541-345-8037
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD51661223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics