Provider Demographics
NPI:1003255589
Name:SEYS, SAMANTHA KAYE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:KAYE
Last Name:SEYS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 W PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-0438
Mailing Address - Country:US
Mailing Address - Phone:507-345-6478
Mailing Address - Fax:
Practice Address - Street 1:530 W PLEASANT ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-0438
Practice Address - Country:US
Practice Address - Phone:507-345-6478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13278122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist