Healthcare Provider Details

I. General information

NPI: 1780599837
Provider Name (Legal Business Name): ABIGAIL MORGAN ERICKSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13899 HIGHWAY 13, FRONTAGE RD
SAVAGE MN
55378
US

IV. Provider business mailing address

1000 W BURNSVILLE PKWY APT 204
BURNSVILLE MN
55337-2347
US

V. Phone/Fax

Practice location:
  • Phone: 952-440-2292
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code125J00000X
TaxonomyDental Therapist
License NumberDT211
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: