MEDICARE: DR. MICHAEL LEE ENGELBRECHT D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	5222	OK

General Provider Information

NPI Number	:	1477618411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL LEE ENGELBRECHT D.D.S.

Provider Business Mailing Address
First Line	:	6565 S YALE AVE
Second Line	:	SUITE 1104
City	:	TULSA
State	:	OK
Zip	:	74136-8378
Country	:	US
Telephone Number	:	918-492-9420
Fax Number	:	918-492-4768

Provider Business Practice Location Address
First Line	:	6565 S YALE AVE
Second Line	:	SUITE 1104
City	:	TULSA
State	:	OK
Zip	:	74136-8378
Country	:	US
Telephone Number	:	918-492-9420
Fax Number	:	918-492-4768

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. MICHAEL LEE ENGELBRECHT D.D.S.” Practice Location

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