Provider Demographics
NPI:1013011451
Name:ERIKSSON, CHRISTOPHER ALGOT (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ALGOT
Last Name:ERIKSSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 S 4TH ST SUITE 101
Mailing Address - Street 2:VALLEY COMMUNITY HEALTH CENTER
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201
Mailing Address - Country:US
Mailing Address - Phone:414-412-2443
Mailing Address - Fax:
Practice Address - Street 1:212 SOUTH 4TH STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201
Practice Address - Country:US
Practice Address - Phone:701-412-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5945-015122300000X
ND1974122300000X
MND12127122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist