Healthcare Provider Details

I. General information

NPI: 1083921886
Provider Name (Legal Business Name): PAUL NMN SEIBEL DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 07/17/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100
APO AE
09180
US

IV. Provider business mailing address

LANDSTUHL REGIONAL MEDICAL CENTER UNIT 33100
APO AE
09180
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-3122
  • Fax:
Mailing address:
  • Phone: 314-590-3122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number7747097-9921
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number7747097-9921
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: