| Shawn T Engebretsen Dmd P A | |
|
841 E Ocean Blvd Stuart FL 34994-2427 | |
| (772) 223-0600 | |
| Not Available |
| Full Name | Shawn T Engebretsen Dmd P A |
|---|---|
| Speciality | Dentist |
| Location | 841 E Ocean Blvd, Stuart, Florida |
| Authorized Official Name and Position | Shawn T Engebretsen (OWNER) |
| Authorized Official Contact | 7722230600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawn T Engebretsen Dmd P A 1825 Nw Bright River Pt Stuart FL 34994-9407 Ph: (772) 692-1194 | Shawn T Engebretsen Dmd P A 841 E Ocean Blvd Stuart FL 34994-2427 Ph: (772) 223-0600 |
| NPI Number | 1225200173 |
|---|---|
| Provider Enumeration Date | 04/01/2008 |
| Last Update Date | 04/08/2010 |
| Medicare PECOS PAC ID | 3779651773 |
|---|---|
| Medicare Enrollment ID | O20081121000630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225200173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | DN0009427 (Florida) | Primary |
| Provider Name | Shawn T Engebretsen |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1396789350 PECOS PAC ID: 5092807180 Enrollment ID: I20070821000252 |
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