MEDICARE: BENJAMIN J. SEATON 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	49800	CA

General Provider Information

NPI Number	:	1619135688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN J. SEATON D.D.S.

Provider Business Mailing Address
First Line	:	816 2ND ST
Second Line	:
City	:	LOS BANOS
State	:	CA
Zip	:	93635-4124
Country	:	US
Telephone Number	:	209-826-8100
Fax Number	:	209-826-0243

Provider Business Practice Location Address
First Line	:	816 2ND ST
Second Line	:
City	:	LOS BANOS
State	:	CA
Zip	:	93635-4124
Country	:	US
Telephone Number	:	209-826-8100
Fax Number	:	209-826-0243

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

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	09/10/2010

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