Provider Demographics
NPI:1235270141
Name:ERHARD, JOHN FREDERICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FREDERICK
Last Name:ERHARD
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:RR 2 BOX 2250
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:PA
Mailing Address - Zip Code:18444-9524
Mailing Address - Country:US
Mailing Address - Phone:570-842-4211
Mailing Address - Fax:570-842-4211
Practice Address - Street 1:RR 2 BOX 2250
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:PA
Practice Address - Zip Code:18444-9524
Practice Address - Country:US
Practice Address - Phone:570-842-4211
Practice Address - Fax:570-842-4211
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018168L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist