Provider Demographics
NPI:1154631737
Name:SEIDEL AND DEFILIPPO DENTISTRY PARTNERSHIP
Entity Type:Organization
Organization Name:SEIDEL AND DEFILIPPO DENTISTRY PARTNERSHIP
Other - Org Name:NULL AND SEIDEL DENTISTRY PARTNERSHIP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:C
Authorized Official - Last Name:SEIDEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-334-8193
Mailing Address - Street 1:353 YORK STREET
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-1953
Mailing Address - Country:US
Mailing Address - Phone:717-334-8193
Mailing Address - Fax:717-334-0884
Practice Address - Street 1:353 YORK STREET
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-1953
Practice Address - Country:US
Practice Address - Phone:717-334-8193
Practice Address - Fax:717-334-0884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-15
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020984L1223G0001X
PADS0359381223G0001X
PADS0381641223P0221X
PADS026326L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty