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General NPI Number Information
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NPI Number | 1316191489
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Entity Type | Organization
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Legal Business Name | ALBERT EHRHARDT'S BEAUTIFUL SMILE DENTAL GROUP
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Dates
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Enumeration Date | 11/15/2008
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Last Update Date | 11/15/2008
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Provider Practice Location Address
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Address Line | 15725 HAWTHORNE BLVD SUITE 102
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City | LAWNDALE
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State | CA
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Zip | 90260-2651
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Country | US
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Telephone | 310-676-7363
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Fax | 310-676-7383
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Provider Business Mailing Address
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Address Line | 15725 HAWTHORNE BLVD SUITE 102
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City | LAWNDALE
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State | CA
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Zip | 90260-2651
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Country | US
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Telephone | 310-676-7363
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Fax | 310-676-7383
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Authorized Official
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Title or Position | DDS
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Name | DR. ALBERT L EHRHARDT
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Credential |
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Telephone | 310-538-4327
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 49512
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License Number State | CA
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