MEDICARE: JOHN H. SEIFERT DMD PC

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	261QD0000X	Dental Clinic/Center	6248	OR

General Provider Information

NPI Number	:	1477726321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN H. SEIFERT DMD PC

Provider Business Mailing Address
First Line	:	2605 12TH PL SE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-2576
Country	:	US
Telephone Number	:	503-585-4281
Fax Number	:	503-585-7427

Provider Business Practice Location Address
First Line	:	2605 12TH PL SE
Second Line	:
City	:	SALEM
State	:	OR
Zip	:	97302-2576
Country	:	US
Telephone Number	:	503-585-4281
Fax Number	:	503-585-7427

Authorized Official
Title or Position	:	OFFIE MANAGER
Name	:	MRS. NANCY S NEVINS
Credential	:
Telephone Number	:	503-585-4281

Provider Enumeration Date	:	04/10/2008
Last Update Date	:	04/10/2008

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