Organization · NPI-2

Barry & Erickson, LLC

Dentist, General Practice · Medford, OR

NPI number1659641504
StatusActive
Last updated in NPPESJan 10, 2012

Details

NPI
1659641504
Entity type
Organization (NPI-2)
Legal business name
Barry & Erickson, LLC
Organization subpart
No
Enumeration date
Jan 10, 2012
Last updated
Jan 10, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice6059ORYes
1223G0001X Dentist, General Practice9139OR
1223G0001X Dentist, General Practice9158OR

Practice location

906 Royal Ct
Medford, OR 97504-6139

Phone 541-779-2634 · Fax 541-779-3282

Mailing address

906 Royal Ct
Medford, OR 97504-6139

Phone 541-779-2634 · Fax 541-779-3282

Authorized official

Anne G Barry
Owner/Dentist
5417792634

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