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General NPI Number Information
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NPI Number | 1295879948
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Entity Type | Individual
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Provider Name | JOHN STEVEN EHRETH D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 10 ROCK POINTE LN STE 5
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City | WARRENTON
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State | VA
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Zip | 20186-2672
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Country | US
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Telephone | 540-351-0009
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Fax | 540-351-0049
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Provider Business Mailing Address
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Address Line | 10 ROCK POINTE LN STE 5
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City | WARRENTON
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State | VA
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Zip | 20186-2672
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Country | US
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Telephone | 540-351-0009
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Fax | 540-351-0049
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 0401007483
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License Number State | VA
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