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NPI 1245550912

NPI 1245550912 : AUSTIN C SEWARD DDS : FRIDLEY, MN

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General NPI Number Information
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    NPI Number           |    1245550912
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    Entity Type          |    Individual 
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    Provider Name        |    AUSTIN C SEWARD DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/04/2010
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    Last Update Date     |    07/25/2014
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Provider Practice Location Address
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    Address Line         |    7136 UNIVERSITY AVE NE 
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    City                 |    FRIDLEY
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    State                |    MN
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    Zip                  |    55432-3100
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    Country              |    US
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    Telephone            |    763-574-1636
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    Fax                  |    763-574-1636
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Provider Business Mailing Address
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    Address Line         |    7136 UNIVERSITY AVE NE 
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    City                 |    FRIDLEY
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    State                |    MN
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    Zip                  |    55432-3100
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    Country              |    US
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    Telephone            |    763-574-1636
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    Fax                  |    763-574-1636
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223S0112X
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    Taxonomy Name        |    Oral and Maxillofacial Surgery (Dentist)
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    License Number       |    D13350
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    License Number State |    MN
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