Provider Demographics
NPI:1639579329
Name:SEUBERT, CHASE H (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHASE
Middle Name:H
Last Name:SEUBERT
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 1:6545 FRANCE AVE S STE 585
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2125
Mailing Address - Country:US
Mailing Address - Phone:952-922-9119
Mailing Address - Fax:
Practice Address - Street 1:6545 FRANCE AVE S STE 585
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2125
Practice Address - Country:US
Practice Address - Phone:952-922-9119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-29
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13389122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist