Provider Demographics
NPI:1225437254
Name:VREEBURG, SEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:
Last Name:VREEBURG
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 1:3599 PINER RD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-3916
Mailing Address - Country:US
Mailing Address - Phone:707-490-9084
Mailing Address - Fax:
Practice Address - Street 1:3599 PINER RD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-3916
Practice Address - Country:US
Practice Address - Phone:707-490-9084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63803122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist