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NPI Code Detail

MEDICARE: DR. KATHY BRISLEY-SEDON DDS

MEDICARE:  DR. KATHY  BRISLEY-SEDON  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
11223G0001XGeneral Practice Dentistry30016116OH

General Provider Information

NPI Number : 1376504613
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHY BRISLEY-SEDON DDS
Provider Business Mailing Address
First Line : 10 W MAIN ST
Second Line :
City : SEVILLE
State : OH
Zip : 44273-8851
Country : US
Telephone Number : 330-769-2918
Fax Number : 330-769-2888
Provider Business Practice Location Address
First Line : 10 W MAIN ST
Second Line :
City : SEVILLE
State : OH
Zip : 44273-8851
Country : US
Telephone Number : 330-769-2918
Fax Number : 330-769-2888
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 07/08/2007

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Directions to “ DR. KATHY BRISLEY-SEDON DDS” Practice Location

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