Provider Demographics
NPI:1184066243
Name:STRAND, ERIC J (DDS)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:J
Last Name:STRAND
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 1:27 MILL AVE
Mailing Address - Street 2:
Mailing Address - City:NEW DOUGLAS
Mailing Address - State:IL
Mailing Address - Zip Code:62074-4026
Mailing Address - Country:US
Mailing Address - Phone:651-968-6574
Mailing Address - Fax:
Practice Address - Street 1:106 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2853
Practice Address - Country:US
Practice Address - Phone:218-739-2297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND138701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice