Healthcare Provider Details

I. General information

NPI: 1144933318
Provider Name (Legal Business Name): ANNA LAURA SEYDEL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E HIGHLAND AVE APT 1183
PHOENIX AZ
85016-4687
US

IV. Provider business mailing address

1601 E HIGHLAND AVE APT 1183
PHOENIX AZ
85016-4687
US

V. Phone/Fax

Practice location:
  • Phone: 503-915-2884
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberD012730
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: