Healthcare Provider Details

I. General information

NPI: 1720371503
Provider Name (Legal Business Name): ERIN BIEBL FINK DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2011
Last Update Date: 04/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 9 BOX 5269
APO AE
09123
US

IV. Provider business mailing address

PSC 9 BOX 5269
APO AE
09123
US

V. Phone/Fax

Practice location:
  • Phone: 707-452-8203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9706
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: