Provider Demographics
NPI:1245240605
Name:KURT A. SEIDLER, D.D.S., INC.
Entity Type:Organization
Organization Name:KURT A. SEIDLER, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:ADIN
Authorized Official - Last Name:SEIDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-492-0411
Mailing Address - Street 1:1930 E ROSEMEADE PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2473
Mailing Address - Country:US
Mailing Address - Phone:972-492-0411
Mailing Address - Fax:972-394-0917
Practice Address - Street 1:1930 E ROSEMEADE PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2473
Practice Address - Country:US
Practice Address - Phone:972-492-0411
Practice Address - Fax:972-394-0917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12622122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty