Provider Demographics
NPI:1205217106
Name:HUIRAS, SETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:
Last Name:HUIRAS
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 1:110 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:MN
Mailing Address - Zip Code:56069-1514
Mailing Address - Country:US
Mailing Address - Phone:507-364-8001
Mailing Address - Fax:507-364-8002
Practice Address - Street 1:110 1ST ST N
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:MN
Practice Address - Zip Code:56069-1514
Practice Address - Country:US
Practice Address - Phone:507-364-8001
Practice Address - Fax:507-364-8002
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001078-15122300000X
MND13630122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist