Provider Demographics
NPI:1740966084
Name:ENGELBRECHT, MORGAN SUZANNE (DDS)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:SUZANNE
Last Name:ENGELBRECHT
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 1:25 IVY LN
Mailing Address - Street 2:
Mailing Address - City:SENOIA
Mailing Address - State:GA
Mailing Address - Zip Code:30276-1553
Mailing Address - Country:US
Mailing Address - Phone:573-263-8818
Mailing Address - Fax:
Practice Address - Street 1:1601 GEORGIAN PARK
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-6968
Practice Address - Country:US
Practice Address - Phone:770-629-9524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00205627122300000X
GADN123349122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist