Provider Demographics
NPI:1295939544
Name:ERICKSON, STEVEN D (DMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:ERICKSON
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 1:2700 GRAND AVE
Mailing Address - Street 2:STE C
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2680
Mailing Address - Country:US
Mailing Address - Phone:406-652-9100
Mailing Address - Fax:406-652-9475
Practice Address - Street 1:2700 GRAND AVE
Practice Address - Street 2:STE C
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2680
Practice Address - Country:US
Practice Address - Phone:406-652-9100
Practice Address - Fax:406-652-9475
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT14781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice