Provider Demographics
NPI:1265631592
Name:ERICKSON, MEGHAN LEIGH (DDS)
Entity Type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:LEIGH
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MISS
Other - First Name:MEGHAN
Other - Middle Name:LEIGH
Other - Last Name:BINIKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1351 FORD ST
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537
Mailing Address - Country:US
Mailing Address - Phone:419-865-8886
Mailing Address - Fax:419-794-7755
Practice Address - Street 1:1351 FORD ST
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537
Practice Address - Country:US
Practice Address - Phone:419-865-8886
Practice Address - Fax:419-794-7755
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0226041223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health