MEDICARE: DR. JEFF M SEIBERT 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	122300000X	Dentist	19808	TX

General Provider Information

NPI Number	:	1306849260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFF M SEIBERT DDS

Provider Business Mailing Address
First Line	:	606 S SEVEN POINTS DR
Second Line	:	# 2
City	:	SEVEN POINTS
State	:	TX
Zip	:	75143-9117
Country	:	US
Telephone Number	:	903-432-2292
Fax Number	:	903-432-3158

Provider Business Practice Location Address
First Line	:	606 S SEVEN POINTS DR
Second Line	:	# 2
City	:	SEVEN POINTS
State	:	TX
Zip	:	75143-9117
Country	:	US
Telephone Number	:	903-432-2292
Fax Number	:	903-432-3158

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/14/2007

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