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General NPI Number Information
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NPI Number | 1134511520
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Entity Type | Individual
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Provider Name | ERICA STOKKE D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 02/23/2015
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Last Update Date | 08/09/2016
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Provider Practice Location Address
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Address Line | 112 S 1ST AVE
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City | LAUREL
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State | MT
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Zip | 59044-3399
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Country | US
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Telephone | 406-628-8211
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Fax |
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Provider Business Mailing Address
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Address Line | 5414 MOLO RD
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City | BILLINGS
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State | MT
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Zip | 59106-3778
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 11470
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License Number State | MT
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