MEDICARE: BARKLEY BOULEVARD DENTAL CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1104774165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARKLEY BOULEVARD DENTAL CARE

Provider Business Mailing Address
First Line	:	2075 BARKLEY BLVD STE 260
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98226-6614
Country	:	US
Telephone Number	:	360-733-8150
Fax Number	:	360-733-8253

Provider Business Practice Location Address
First Line	:	2075 BARKLEY BLVD STE 260
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98226-6614
Country	:	US
Telephone Number	:	360-733-8150
Fax Number	:	360-733-8253

Authorized Official
Title or Position	:	DENTIST / OWNER
Name	:	LES BOULEVARD DENTAL SEELYE
Credential	:	DDS
Telephone Number	:	360-733-8150

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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