MEDICARE: DR. JOHN H. SEIFERT DMD

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	1223P0300X	Periodontics	D6248	OR

General Provider Information

NPI Number	:	1932106226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN H. SEIFERT DMD

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	07/08/2007

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