Provider Demographics
NPI:1477812881
Name:BRASSER, ANDREW JACOB (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JACOB
Last Name:BRASSER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7806 MARKET BLVD
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-9440
Mailing Address - Country:US
Mailing Address - Phone:952-303-7003
Mailing Address - Fax:
Practice Address - Street 1:7806 MARKET BLVD
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-9440
Practice Address - Country:US
Practice Address - Phone:952-303-7003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-07
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND133571223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics