MEDICARE: DR. JAMES MATTISON SEALE DDS

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	9380	TX

General Provider Information

NPI Number	:	1114029915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES MATTISON SEALE DDS

Provider Business Mailing Address
First Line	:	4130 BELLAIRE
Second Line	:	SUITE 212
City	:	HOUSTON
State	:	TX
Zip	:	77025-1056
Country	:	US
Telephone Number	:	713-667-3430
Fax Number	:	713-667-4430

Provider Business Practice Location Address
First Line	:	4130 BELLAIRE
Second Line	:	SUITE 212
City	:	HOUSTON
State	:	TX
Zip	:	77025-1056
Country	:	US
Telephone Number	:	713-667-3430
Fax Number	:	713-667-4430

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

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	07/08/2007

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