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General NPI Number Information
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NPI Number | 1518408269
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Entity Type | Individual
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Provider Name | SETH THOMAS DAHLE D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/14/2017
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 31ST MEDICAL GROUP/SGHC UNIT 6180
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City | APO
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State | AE
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Zip | 09604
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Country | US
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Telephone | 314-632-5060
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Fax |
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Provider Business Mailing Address
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Address Line | UNIT 6180 BOX 31ST
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City | APO
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State | AE
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Zip | 09604-6180
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Country | US
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Telephone |
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Fax |
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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 | D009773
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2397
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License Number State | ND
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D009773
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License Number State | AZ
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