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General NPI Number Information
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NPI Number | 1679756597
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Entity Type | Organization
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Legal Business Name | ROBERT L SEYMOUR DDS PA
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 2711 RANDOLPH RD STE 510
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City | CHARLOTTE
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State | NC
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Zip | 28207-2027
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Country | US
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Telephone | 704-377-9065
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Fax | 704-377-1437
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Provider Business Mailing Address
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Address Line | 2711 RANDOLPH RD STE 510
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City | CHARLOTTE
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State | NC
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Zip | 28207-2027
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Country | US
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Telephone | 704-377-9065
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Fax | 704-377-1437
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ROBERT LEE SEYMOUR
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Credential | DDS
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Telephone | 704-377-9065
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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 | 4112
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License Number State | NC
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