MEDICARE: GEORGE N SELIGMAN DDS

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	2901011122	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2901011122	OTHER	MI	STATE OF MICHIGAN DENTAL LICENSE

General Provider Information

NPI Number	:	1164623732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGE N SELIGMAN DDS

Provider Business Mailing Address
First Line	:	33200 W 14 MILE RD
Second Line	:	SUITE 100
City	:	W BLOOMFIELD
State	:	MI
Zip	:	48322-3563
Country	:	US
Telephone Number	:	248-406-0180
Fax Number	:	248-406-5088

Provider Business Practice Location Address
First Line	:	33200 W 14 MILE RD
Second Line	:	SUITE 100
City	:	W BLOOMFIELD
State	:	MI
Zip	:	48322-3563
Country	:	US
Telephone Number	:	248-406-0180
Fax Number	:	248-406-5088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	03/17/2022

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Directions to “ GEORGE N SELIGMAN DDS” Practice Location

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