Healthcare Provider Details

I. General information

NPI: 1669905352
Provider Name (Legal Business Name): WILLIAM F SEEFRIED JR., D.M.D., PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 04/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2183 SE OCEAN BLVD
STUART FL
34996-3305
US

IV. Provider business mailing address

2183 SE OCEAN BLVD
STUART FL
34996-3305
US

V. Phone/Fax

Practice location:
  • Phone: 772-283-6245
  • Fax:
Mailing address:
  • Phone: 772-283-6245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN 22436
License Number StateFL

VIII. Authorized Official

Name: DR. WILLIAM FREDERICK SEEFRIED JR.
Title or Position: DENTIST
Credential: D.M.D.
Phone: 215-850-7007