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NPI Code Detail

MEDICARE: DR. GEOFFREY S SEIDL DDS

MEDICARE: DR. GEOFFREY S SEIDL 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
1122300000XDentist12013378AIN

General Provider Information

NPI Number : 1548884711
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEOFFREY S SEIDL DDS
Provider Business Mailing Address
First Line : 1855 STAFFORD RD
Second Line :
City : PLAINFIELD
State : IN
Zip : 46168-2338
Country : US
Telephone Number : 317-839-2088
Fax Number :
Provider Business Practice Location Address
First Line : 1855 STAFFORD RD
Second Line :
City : PLAINFIELD
State : IN
Zip : 46168-2338
Country : US
Telephone Number : 317-839-2088
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2020
Last Update Date : 06/03/2020

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