Provider Demographics
NPI:1427108745
Name:ERDMAN, JOSEPH F (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:ERDMAN
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 1:7770 ASHWOOD DR SE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-8745
Mailing Address - Country:US
Mailing Address - Phone:616-682-9210
Mailing Address - Fax:
Practice Address - Street 1:6886 CASCADE RD SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-6879
Practice Address - Country:US
Practice Address - Phone:616-940-4777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010131391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice