Healthcare Provider Details

I. General information

NPI: 1023069549
Provider Name (Legal Business Name): JOHN F LEHRIAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 STATE ST SUITE B102
ERIE PA
16507-1452
US

IV. Provider business mailing address

100 STATE ST SUITE B102
ERIE PA
16507-1452
US

V. Phone/Fax

Practice location:
  • Phone: 814-454-3871
  • Fax: 814-454-6294
Mailing address:
  • Phone: 814-454-3871
  • Fax: 814-454-6294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS017478L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: