Healthcare Provider Details

I. General information

NPI: 1811924269
Provider Name (Legal Business Name): SCOTT DAVIN SEILER D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5118 N. 156TH STREET
OMAHA NE
68116-3226
US

IV. Provider business mailing address

15710 WILLIAM COURT #106
OMAHA NE
68130-2593
US

V. Phone/Fax

Practice location:
  • Phone: 402-932-9263
  • Fax: 402-991-0404
Mailing address:
  • Phone: 402-850-9936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number6335
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: