Provider Demographics
NPI:1164623732
Name:SELIGMAN, GEORGE N (DDS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:N
Last Name:SELIGMAN
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 1:33200 W 14 MILE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:W BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3563
Mailing Address - Country:US
Mailing Address - Phone:248-406-0180
Mailing Address - Fax:248-406-5088
Practice Address - Street 1:33200 W 14 MILE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:W BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3563
Practice Address - Country:US
Practice Address - Phone:248-406-0180
Practice Address - Fax:248-406-5088
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010111221223G0001X
MI2901011121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2901011122OtherSTATE OF MICHIGAN DENTAL LICENSE