Healthcare Provider Details

I. General information

NPI: 1316508690
Provider Name (Legal Business Name): MARISOL ANN SEYS HERR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARISOL ANN SEYS DDS

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MARSHALL ST
LITCHFIELD MI
49252-9145
US

IV. Provider business mailing address

515 MARSHALL ST
LITCHFIELD MI
49252-9145
US

V. Phone/Fax

Practice location:
  • Phone: 517-542-2941
  • Fax: 517-325-2806
Mailing address:
  • Phone: 319-883-9214
  • Fax: 517-235-2806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2901023164
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901023164
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: