Forsberg, Eric Jon

Forsberg, Eric Jon is an sole proprietor health care provider with primary practice located at 1422 1St Ave E , Newton IA 50208-4005. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Forsberg, Eric Jon can be contacted via phone (641) 792-2598.

Contact Information

Primary practice address
1422 1St Ave E Newton IA 50208-4005
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 8202 Iowa

Profile Details

NPI number 1225146525
LBN Legal business name Forsberg, Eric Jon
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 27th, 2006
Last updated Jul 8th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225146525 NPPES
Iowa Other 34709 WELLMARK BLUEDENTAL
Iowa Other 1489335 WELLMARK BLUEDENTAL
Iowa MEDICAID 0290619 WELLMARK BLUEDENTAL

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