Healthcare Provider Details

I. General information

NPI: 1306884044
Provider Name (Legal Business Name): DOUGLAS H SEEGER DMD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 01/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

992 MANTUA PIKE SUITE 302 WESTWOOD ORAL SURGERY ASSOCIATES PA
WOODBURY HEIGHTS NJ
08097
US

IV. Provider business mailing address

992 MANTUA PIKE SUITE 302 WESTWOOD ORAL SURGERY ASSOCIATES PA
WOODBURY HEIGHTS NJ
08097
US

V. Phone/Fax

Practice location:
  • Phone: 856-845-1341
  • Fax: 856-384-9067
Mailing address:
  • Phone: 856-845-1341
  • Fax: 856-384-9067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number22D102314600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDS031358L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: