Provider Demographics
NPI:1013184993
Name:EHRLICH, BRIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:EHRLICH
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:PO BOX 543
Mailing Address - Street 2:
Mailing Address - City:TALLMAN
Mailing Address - State:NY
Mailing Address - Zip Code:10982-0543
Mailing Address - Country:US
Mailing Address - Phone:914-393-5297
Mailing Address - Fax:
Practice Address - Street 1:300 SYLVAN AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2525
Practice Address - Country:US
Practice Address - Phone:914-393-5297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-10
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ181781223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics