Provider Demographics
NPI:1891853867
Name:ENGLEHART, DAVID ROBERT (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROBERT
Last Name:ENGLEHART
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 REGENT CT
Mailing Address - Street 2:SUITE D
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7969
Mailing Address - Country:US
Mailing Address - Phone:814-238-6734
Mailing Address - Fax:814-238-9581
Practice Address - Street 1:220 REGENT CT
Practice Address - Street 2:SUITE D
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7969
Practice Address - Country:US
Practice Address - Phone:814-238-6734
Practice Address - Fax:814-238-9581
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-027885-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice