Provider Demographics
NPI:1205020260
Name:EHRLICH, MARC B (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:B
Last Name:EHRLICH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1371 BEACON ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4905
Mailing Address - Country:US
Mailing Address - Phone:617-566-2734
Mailing Address - Fax:
Practice Address - Street 1:1371 BEACON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4905
Practice Address - Country:US
Practice Address - Phone:617-566-2734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155321223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics