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General NPI Number Information
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NPI Number | 1558600288
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Entity Type | Organization
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Legal Business Name | J. STEPHEN SELDEN DDS AND ASSOCIATES, PA
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Dates
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Enumeration Date | 01/31/2013
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Last Update Date | 07/15/2015
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Provider Practice Location Address
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Address Line | 1107 STATESVILLE BLVD
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City | SALISBURY
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State | NC
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Zip | 28144-2287
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Country | US
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Telephone | 704-637-6717
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Fax |
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Provider Business Mailing Address
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Address Line | 1107 STATESVILLE BLVD
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City | SALISBURY
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State | NC
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Zip | 28144-2287
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Country | US
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Telephone | 704-637-6717
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JOHN STEPHEN SELDEN
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Credential | DDS
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Telephone | 704-637-6717
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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 | 9850
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License Number State | NC
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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 | 9233
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7048
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License Number State | NC
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