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DR. ERIC SCOTT BJERKE D.M.D
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1518376664
Individual Registrant:DR. ERIC SCOTT BJERKE D.M.D
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
13395 N MARANA MAIN ST MARANA, AZ 85653-7008 US
Tel: 520-616-6200 Fax: 520-682-1087
Tel: 520-616-6200 Fax: 520-682-1087
Contact information for business:
PO BOX 188 MARANA, AZ 85653-0188 US
Tel: 520-682-4111 Fax: 520-818-3630
Tel: 520-682-4111 Fax: 520-818-3630
Registration Information:
NPI: 1518376664
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | AZ | D009034 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 930685 | AZ | 05 |
