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General NPI Number Information
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NPI Number | 1689711541
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Entity Type | Organization
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Legal Business Name | DUANE ERICKSON, DDS
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 04/14/2011
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Provider Practice Location Address
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Address Line | 13321 NEW HAMPSHIRE AVE SUITE 206
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City | SILVER SPRING
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State | MD
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Zip | 20904-3450
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Country | US
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Telephone | 301-236-0600
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Fax | 301-236-9587
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Provider Business Mailing Address
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Address Line | 13321 NEW HAMPSHIRE AVE SUITE 206
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City | SILVER SPRING
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State | MD
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Zip | 20904-3450
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Country | US
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Telephone | 301-236-0600
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Fax | 301-236-9587
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Authorized Official
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Title or Position | OWNER
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Name | DR. DUANE ERICKSON
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Credential | DDS
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Telephone | 301-236-0600
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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 | 7215
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License Number State | MD
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