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General NPI Number Information
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NPI Number | 1932525102
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Entity Type | Organization
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Legal Business Name | JMS GREENVILLE DENTAL PLLC
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Dates
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Enumeration Date | 03/12/2014
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 5006 WESLEY ST
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City | GREENVILLE
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State | TX
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Zip | 75402-6307
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Country | US
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Telephone | 214-995-5149
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Fax | 214-367-5896
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Provider Business Mailing Address
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Address Line | PO BOX 543248
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City | GRAND PRAIRIE
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State | TX
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Zip | 75054-3248
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Country | US
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Telephone | 214-995-5149
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Fax | 214-367-5896
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Authorized Official
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Title or Position | OWNER/ DENTIST
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Name | DR. JEFFERY M SEIBERT
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Credential | D.D.S.
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Telephone | 903-288-9066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 19808
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License Number State | TX
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