Provider Demographics
NPI:1588833313
Name:ENGELHARDT, ZORICA (DDS)
Entity Type:Individual
Prefix:
First Name:ZORICA
Middle Name:
Last Name:ENGELHARDT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 HAZARD AVE STE C3
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-4587
Mailing Address - Country:US
Mailing Address - Phone:860-763-5522
Mailing Address - Fax:860-763-5521
Practice Address - Street 1:150 HAZARD AVE STE C3
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-4587
Practice Address - Country:US
Practice Address - Phone:860-763-5522
Practice Address - Fax:860-763-5521
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT90521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice