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NPI 1346467206

NPI 1346467206 : JOSHUA ERICKSON DDS MSD : COLORADO SPRINGS, CO

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General NPI Number Information
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    NPI Number           |    1346467206
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    Entity Type          |    Individual 
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    Provider Name        |    JOSHUA ERICKSON DDS MSD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/19/2007
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    Last Update Date     |    04/05/2022
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Provider Practice Location Address
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    Address Line         |    9334 GRAND CORDERA PKWY 
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    City                 |    COLORADO SPRINGS
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    State                |    CO
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    Zip                  |    80924-7000
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    Country              |    US
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    Telephone            |    719-282-6666
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    Fax                  |    719-203-5477
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Provider Business Mailing Address
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    Address Line         |    9334 GRAND CORDERA PKWY 
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    City                 |    COLORADO SPRINGS
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    State                |    CO
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    Zip                  |    80924-7000
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    Country              |    US
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    Telephone            |    719-439-9476
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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        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    DEN 9665
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    License Number State |    CO
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Taxonomy #2
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    Taxonomy Code        |    1223P0221X
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    Taxonomy Name        |    Pediatric Dentistry
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    License Number       |    DEN 9665
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    License Number State |    CO
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