Provider Demographics
NPI:1033210877
Name:SEYMORE, N KIMMEY III (DDS)
Entity Type:Individual
Prefix:
First Name:N
Middle Name:KIMMEY
Last Name:SEYMORE
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 VILLAGE WAY
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562
Mailing Address - Country:US
Mailing Address - Phone:252-633-4444
Mailing Address - Fax:252-638-1586
Practice Address - Street 1:2815 VILLAGE WAY
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562
Practice Address - Country:US
Practice Address - Phone:252-633-4444
Practice Address - Fax:252-638-1586
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC57811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8997718Medicaid
NC97718OtherBLUE CROSS BLUE SHIELD
NC565707OtherUNITED CONCORDIA
NCU39104Medicare UPIN