Provider Demographics
NPI:1043473564
Name:SEYMOUR, ROBERT JEFFERSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JEFFERSON
Last Name:SEYMOUR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2880 E GERMANN RD
Mailing Address - Street 2:SUITE 13
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-1410
Mailing Address - Country:US
Mailing Address - Phone:480-821-5444
Mailing Address - Fax:
Practice Address - Street 1:2880 E GERMANN RD
Practice Address - Street 2:SUITE 13
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-1410
Practice Address - Country:US
Practice Address - Phone:480-821-5444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD7566122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist