Provider Demographics
NPI:1093064602
Name:SEIBERT, CHRISTOPHER HEATH (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:HEATH
Last Name:SEIBERT
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 1:30 CHANDLER CENTER
Mailing Address - Street 2:
Mailing Address - City:HARTWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30643
Mailing Address - Country:US
Mailing Address - Phone:706-376-7147
Mailing Address - Fax:706-377-4797
Practice Address - Street 1:30 CHANDLER CENTER
Practice Address - Street 2:
Practice Address - City:HARTWELL
Practice Address - State:GA
Practice Address - Zip Code:30643
Practice Address - Country:US
Practice Address - Phone:706-376-7147
Practice Address - Fax:706-377-4797
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0144421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice