Ericson, Paul
Ericson, Paul is an individual health care provider with primary practice located at 15 Deerwood Ln , Saranac Lake NY 12983-3324. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Ericson, Paul can be contacted via phone (518) 891-3856.Contact Information
Primary practice address
15 Deerwood Ln
Saranac Lake NY 12983-3324
Phone: (518) 891-3856
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 0329701 | New York |
Profile Details
| NPI number | 1326268616 |
|---|---|
| LBN Legal business name | Ericson, Paul |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 27th, 2007 |
| Last updated | Jun 9th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326268616 | NPPES |
| New York | MEDICAID | 00583702 |
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