Provider Demographics
NPI:1154429272
Name:SKATVOLD, ERIK PAHL (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:PAHL
Last Name:SKATVOLD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 8TH ST S
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-3605
Mailing Address - Country:US
Mailing Address - Phone:218-236-5466
Mailing Address - Fax:218-236-4948
Practice Address - Street 1:1401 8TH ST S
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-3605
Practice Address - Country:US
Practice Address - Phone:218-236-5466
Practice Address - Fax:218-236-4948
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND114221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice