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General NPI Number Information
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NPI Number | 1801041611
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Entity Type | Organization
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Legal Business Name | CHAD R. SEABOLD, DDS, MD, PA ORAL & MAXILLOFACIAL SURGERY
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 11/20/2008
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Provider Practice Location Address
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Address Line | 5959 WEST LOOP SOUTH SUITE 620
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City | BELLAIRE
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State | TX
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Zip | 77401
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Country | US
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Telephone | 713-981-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 5959 WEST LOOP SOUTH SUITE 620
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City | BELLAIRE
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State | TX
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Zip | 77401
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Country | US
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Telephone | 713-981-0000
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Fax |
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Authorized Official
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Title or Position | ORAL AND MAXILLOFACIAL SURGEON
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Name | DR. CHAD RUSSELL SEABOLD
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Credential | MD, DDS
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Telephone | 713-981-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | N1442
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License Number State | TX
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