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General NPI Number Information
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NPI Number | 1013139310
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Entity Type | Organization
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Legal Business Name | JOHN S.SELDEN,DDS,PA
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 01/25/2011
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Provider Practice Location Address
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Address Line | 2315 WEST ARBORS DRIVE SUITE 220
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City | CHARLOTTE
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State | NC
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Zip | 28262-2639
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Country | US
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Telephone | 704-597-3493
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Fax | 704-597-3494
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Provider Business Mailing Address
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Address Line | 2315 WEST ARBORS DRIVE SUITE 220
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City | CHARLOTTE
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State | NC
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Zip | 28262-2639
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Country | US
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Telephone | 704-597-3493
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Fax | 704-597-3494
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JOHN STEPHEN SELDEN
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Credential | DDS
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Telephone | 704-597-3493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7048
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License Number State | NC
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