Healthcare Provider Details

I. General information

NPI: 1144742065
Provider Name (Legal Business Name): ERIC VEIT SESSELMANN JR. DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 02/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4382 HENRY ST
NORTON SHORES MI
49441-4975
US

IV. Provider business mailing address

418 SUMMIT AVE
JERSEY CITY NJ
07306-3101
US

V. Phone/Fax

Practice location:
  • Phone: 231-798-3431
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DR03172
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901022698
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: