Provider Demographics
NPI:1073892881
Name:ERSLAND, RYAN P (DMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:P
Last Name:ERSLAND
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 GAMBELL ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2838
Mailing Address - Country:US
Mailing Address - Phone:907-276-1621
Mailing Address - Fax:907-279-0562
Practice Address - Street 1:2525 GAMBELL ST
Practice Address - Street 2:SUITE 304
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2838
Practice Address - Country:US
Practice Address - Phone:907-276-1621
Practice Address - Fax:907-279-0562
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK13931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice