Provider Demographics
NPI:1659536142
Name:PRICE, ERIN CARLSON (DMD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:CARLSON
Last Name:PRICE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8289 MT HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:BIGFORK
Mailing Address - State:MT
Mailing Address - Zip Code:59911-3518
Mailing Address - Country:US
Mailing Address - Phone:406-837-5611
Mailing Address - Fax:
Practice Address - Street 1:8289 MT HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:BIGFORK
Practice Address - State:MT
Practice Address - Zip Code:59911-3518
Practice Address - Country:US
Practice Address - Phone:406-837-5611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2370122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist