Provider Demographics
NPI:1245379098
Name:DAHLEN, ERIC N (DMD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:N
Last Name:DAHLEN
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 1:8720 NE CENTERPOINTE DR
Mailing Address - Street 2:SUITE B221
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-1160
Mailing Address - Country:US
Mailing Address - Phone:360-213-1999
Mailing Address - Fax:360-326-1648
Practice Address - Street 1:8720 NE CENTERPOINTE DR
Practice Address - Street 2:SUITE B221
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-1160
Practice Address - Country:US
Practice Address - Phone:360-213-1999
Practice Address - Fax:360-326-1648
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000083571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice