Healthcare Provider Details

I. General information

NPI: 1598125494
Provider Name (Legal Business Name): SEBASTIEN MIOT DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2016
Last Update Date: 03/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 RIPLEY ST #1611
SILVER SPRING MD
20910-7438
US

IV. Provider business mailing address

1155 RIPLEY ST #1611
SILVER SPRING MD
20910-7438
US

V. Phone/Fax

Practice location:
  • Phone: 202-455-6468
  • Fax:
Mailing address:
  • Phone: 202-455-6468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number16250
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: