Provider Demographics
NPI:1083774087
Name:EHRHART, LAWRENCE EUGENE JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:EUGENE
Last Name:EHRHART
Suffix:JR
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 1:620 COLLINS DR
Mailing Address - Street 2:P O BOX 372
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-2077
Mailing Address - Country:US
Mailing Address - Phone:636-937-9152
Mailing Address - Fax:636-937-9153
Practice Address - Street 1:620 COLLINS DR
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-2077
Practice Address - Country:US
Practice Address - Phone:636-937-9152
Practice Address - Fax:636-937-9153
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO129751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice