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General NPI Number Information
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NPI Number | 1649635061
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Entity Type | Organization
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Legal Business Name | KRISTINE E SEIBEL DMD LLC
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Dates
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Enumeration Date | 12/30/2015
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Last Update Date | 12/30/2015
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Provider Practice Location Address
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Address Line | 410 BOSTON POST RD
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City | SUDBURY
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State | MA
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Zip | 01776-3058
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Country | US
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Telephone | 978-443-5431
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Fax |
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Provider Business Mailing Address
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Address Line | 410 BOSTON POST RD
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City | SUDBURY
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State | MA
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Zip | 01776-3058
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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 | MEMBER
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Name | DR. KRISTINE E SEIBEL
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Credential | D.M.D.
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Telephone | 978-443-5431
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN1856182
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN19515
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License Number State | MA
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