Provider Demographics
NPI:1083784268
Name:SELVIG, DAVID W (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:SELVIG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 PACIFIC AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-2138
Mailing Address - Country:US
Mailing Address - Phone:724-224-0790
Mailing Address - Fax:724-224-2136
Practice Address - Street 1:1600 PACIFIC AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-2138
Practice Address - Country:US
Practice Address - Phone:724-224-0790
Practice Address - Fax:724-224-2136
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020210L1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry