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General NPI Number Information
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NPI Number | 1750667564
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Entity Type | Organization
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Legal Business Name | JOHN F SEIDEL DDS PA
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Dates
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Enumeration Date | 10/25/2011
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Last Update Date | 10/25/2011
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Provider Practice Location Address
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Address Line | 1346 S DIVISION ST SUITE 102
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City | SALISBURY
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State | MD
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Zip | 21804-7021
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Country | US
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Telephone | 410-749-6822
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Fax |
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Provider Business Mailing Address
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Address Line | 1346 S DIVISION ST SUITE 102
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City | SALISBURY
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State | MD
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Zip | 21804-7021
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Country | US
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Telephone | 410-749-6822
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN FREDERICK SEIDEL
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Credential | DDS
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Telephone | 410-749-6822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number | 11378
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License Number State | MD
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