Provider Demographics
NPI:1164901542
Name:SEALS, AWBREY (DMD)
Entity Type:Individual
Prefix:DR
First Name:AWBREY
Middle Name:
Last Name:SEALS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:AWBREY
Other - Middle Name:
Other - Last Name:LANDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 TENOR LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-5433
Mailing Address - Country:US
Mailing Address - Phone:253-509-4947
Mailing Address - Fax:253-509-4947
Practice Address - Street 1:DAVIS DENTAL CLINIC BLDG 4-1838 NORMANDY DRICVE
Practice Address - Street 2:
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28310-7302
Practice Address - Country:US
Practice Address - Phone:910-432-4227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13224122300000X
SCDGD.10637122300000X
ORD10882122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist