Healthcare Provider Details

I. General information

NPI: 1427036250
Provider Name (Legal Business Name): JOHN D SEITZ D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 N SUMMIT ST
ARKANSAS CITY KS
67005-2229
US

IV. Provider business mailing address

625 N SUMMIT ST
ARKANSAS CITY KS
67005-2229
US

V. Phone/Fax

Practice location:
  • Phone: 620-442-7752
  • Fax: 620-442-3042
Mailing address:
  • Phone: 620-442-7752
  • Fax: 620-442-3042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6399
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: