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General NPI Number Information
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NPI Number | 1255538476
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Entity Type | Individual
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Provider Name | SAMUEL ROBERT SELZER DMD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5 N HADDON AVE
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City | HADDONFIELD
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State | NJ
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Zip | 08033
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Country | US
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Telephone | 856-429-5612
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Fax | 856-429-8388
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Provider Business Mailing Address
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Address Line | 193 LINDEN DRIVE
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City | ELKINS PARK
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State | PA
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Zip | 19027
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Country | US
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Telephone | 215-884-0477
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Fax | 215-884-6045
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 22D100876100
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License Number State | NJ
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