Provider Demographics
NPI:1326249897
Name:EHRHARDT, ALBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:
Last Name:EHRHARDT
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 1:1400 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:IOWA PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76367-1100
Mailing Address - Country:US
Mailing Address - Phone:940-592-9880
Mailing Address - Fax:940-592-9881
Practice Address - Street 1:1400 JOHNSON RD
Practice Address - Street 2:
Practice Address - City:IOWA PARK
Practice Address - State:TX
Practice Address - Zip Code:76367-1100
Practice Address - Country:US
Practice Address - Phone:940-592-9880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49512122300000X
TX27807122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist