MEDICARE: DR. STEPHEN THOMAS ANDREW SEHEULT 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	122300000X	Dentist	57305	CA
2	122300000X	Dentist	13301	MT

General Provider Information

NPI Number	:	1508021510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN THOMAS ANDREW SEHEULT D.D.S

Provider Business Mailing Address
First Line	:	PO BOX 2015
Second Line	:	211 5TH STREET WEST
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912
Country	:	US
Telephone Number	:	406-892-4348
Fax Number	:	406-892-4814

Provider Business Practice Location Address
First Line	:	211 5TH ST W
Second Line	:
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912-3607
Country	:	US
Telephone Number	:	406-892-4348
Fax Number	:	406-892-4814

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

Provider Enumeration Date	:	07/20/2008
Last Update Date	:	07/21/2022

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