Provider Demographics
NPI:1912922709
Name:EHRHARDT, FERNANDO J (DMD)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:J
Last Name:EHRHARDT
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 1:738 ROUTE 9 STE. 22
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524
Mailing Address - Country:US
Mailing Address - Phone:845-896-5151
Mailing Address - Fax:845-896-0974
Practice Address - Street 1:738 ROUTE 9 STE. 22
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524
Practice Address - Country:US
Practice Address - Phone:845-896-5151
Practice Address - Fax:845-896-0974
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048977-11223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics