Healthcare Provider Details

I. General information

NPI: 1821638206
Provider Name (Legal Business Name): SAMANTHA DIANE SEITZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2020
Last Update Date: 01/13/2020
Certification Date: 01/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 SEMINARY DR BLDG E
GREENSBURG PA
15601-3734
US

IV. Provider business mailing address

6342 MARCHAND ST APT 2
PITTSBURGH PA
15206-4312
US

V. Phone/Fax

Practice location:
  • Phone: 724-552-2950
  • Fax:
Mailing address:
  • Phone: 772-643-5158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS041996
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: