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General NPI Number Information
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NPI Number | 1134540248
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Entity Type | Organization
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Legal Business Name | DAN C. SELZ DDS DEBORAH J. SELZ DDS
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Dates
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Enumeration Date | 12/17/2013
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Last Update Date | 12/17/2013
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Provider Practice Location Address
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Address Line | 811 HALSELL ST
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City | BRIDGEPORT
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State | TX
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Zip | 76426-3025
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Country | US
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Telephone | 940-683-4077
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Fax | 940-683-2935
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Provider Business Mailing Address
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Address Line | 811 HALSELL ST
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City | BRIDGEPORT
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State | TX
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Zip | 76426-3025
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Country | US
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Telephone | 940-683-4077
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Fax | 940-683-2935
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Authorized Official
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Title or Position | DR DAN SELZ
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Name | DR. DAN C. SELZ
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Credential | DDS
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Telephone | 940-683-4077
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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 | 13946
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License Number State | TX
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