Provider Demographics
NPI:1164648366
Name:SEIDEL, SHELLEY LYNN (DDS MD)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:LYNN
Last Name:SEIDEL
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Gender:F
Credentials:DDS MD
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Mailing Address - Street 1:8800 KATY FWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1633
Mailing Address - Country:US
Mailing Address - Phone:713-464-2833
Mailing Address - Fax:713-464-7563
Practice Address - Street 1:8800 KATY FWY
Practice Address - Street 2:SUITE 210
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1633
Practice Address - Country:US
Practice Address - Phone:713-464-2833
Practice Address - Fax:713-464-7563
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2008-04-18
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Provider Licenses
StateLicense IDTaxonomies
TX199131223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery