Provider Demographics
NPI:1902010275
Name:ENGELBRECHT, CHAD (DDS)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:ENGELBRECHT
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 1:7650 CURRELL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-8209
Mailing Address - Country:US
Mailing Address - Phone:651-730-9266
Mailing Address - Fax:651-578-0444
Practice Address - Street 1:7650 CURRELL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-8209
Practice Address - Country:US
Practice Address - Phone:651-730-9266
Practice Address - Fax:651-578-0444
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN11433122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist