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General NPI Number Information
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NPI Number | 1699783480
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Entity Type | Individual
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Provider Name | CORY B SELLERS D.D.S.,M.S.D
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 60 REMICK BLVD
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City | SPRINGBORO
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State | OH
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Zip | 45066-9168
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Country | US
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Telephone | 937-350-5379
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Fax | 937-350-5409
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Provider Business Mailing Address
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Address Line | 60 REMICK BLVD
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City | SPRINGBORO
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State | OH
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Zip | 45066-9168
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Country | US
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Telephone | 317-523-9039
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 12010228B
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12010228B
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 30-022269
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License Number State | OH
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