Provider Demographics
NPI:1164585493
Name:NOLTING, ERICK WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERICK
Middle Name:WILLIAM
Last Name:NOLTING
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 1:1400 HAWTHORNE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-4550
Mailing Address - Country:US
Mailing Address - Phone:320-762-0217
Mailing Address - Fax:320-762-1084
Practice Address - Street 1:1400 HAWTHORNE ST
Practice Address - Street 2:SUITE #3
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-4549
Practice Address - Country:US
Practice Address - Phone:320-762-0217
Practice Address - Fax:320-762-1084
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND11798122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist