MEDICARE: DR. FRANK S SEO D.D.S.

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	32394	CA

General Provider Information

NPI Number	:	1467414524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK S SEO D.D.S.

Provider Business Mailing Address
First Line	:	1330 SAN BERNARDINO RD
Second Line	:	SUITE A
City	:	UPLAND
State	:	CA
Zip	:	91786-4928
Country	:	US
Telephone Number	:	909-981-8934
Fax Number	:	909-981-8936

Provider Business Practice Location Address
First Line	:	1330 SAN BERNARDINO RD
Second Line	:	SUITE A
City	:	UPLAND
State	:	CA
Zip	:	91786-4928
Country	:	US
Telephone Number	:	909-981-8934
Fax Number	:	909-981-8936

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

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	11/19/2012

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