Provider Demographics
NPI:1982966529
Name:WERT, CHAD JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:JOSEPH
Last Name:WERT
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 1:739 REGAL RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-7972
Mailing Address - Country:US
Mailing Address - Phone:715-760-2331
Mailing Address - Fax:
Practice Address - Street 1:13961 60TH ST N
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-1053
Practice Address - Country:US
Practice Address - Phone:651-439-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13118122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist