Provider Demographics
NPI:1790993582
Name:EHRMAN, BRIAN DAVID (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:DAVID
Last Name:EHRMAN
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 1:102 MONTELEON CIR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-4737
Mailing Address - Country:US
Mailing Address - Phone:740-386-5843
Mailing Address - Fax:740-387-1384
Practice Address - Street 1:2914 BETIN AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7258
Practice Address - Country:US
Practice Address - Phone:318-323-4450
Practice Address - Fax:318-323-4430
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH18754122300000X
LA74851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist