Provider Demographics
NPI:1952388605
Name:EHRMANNTRAUT, RICHARD CHARLES (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:CHARLES
Last Name:EHRMANNTRAUT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:91 SNELLING AVE N
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-6753
Mailing Address - Country:US
Mailing Address - Phone:651-646-3735
Mailing Address - Fax:651-641-1788
Practice Address - Street 1:91 SNELLING AVE N
Practice Address - Street 2:SUITE 110
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-6753
Practice Address - Country:US
Practice Address - Phone:651-646-3735
Practice Address - Fax:651-641-1788
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN87481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice