Provider Demographics
NPI:1164556015
Name:SEASLY, WILLIAM BRUCE (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BRUCE
Last Name:SEASLY
Suffix:
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 1:8150 W 111TH ST STE 4
Mailing Address - Street 2:
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-2591
Mailing Address - Country:US
Mailing Address - Phone:630-956-0445
Mailing Address - Fax:
Practice Address - Street 1:5875 LANDERBROOK DR STE 250
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-6502
Practice Address - Country:US
Practice Address - Phone:800-487-4867
Practice Address - Fax:216-593-7533
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0272391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice