Provider Demographics
NPI:1275061590
Name:SEAMOUNT, CORAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CORAL
Middle Name:
Last Name:SEAMOUNT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1669 MAPLE AVE APT 18
Mailing Address - Street 2:
Mailing Address - City:SOLVANG
Mailing Address - State:CA
Mailing Address - Zip Code:93463-2646
Mailing Address - Country:US
Mailing Address - Phone:561-212-3648
Mailing Address - Fax:
Practice Address - Street 1:377 1ST ST
Practice Address - Street 2:
Practice Address - City:SOLVANG
Practice Address - State:CA
Practice Address - Zip Code:93463-2711
Practice Address - Country:US
Practice Address - Phone:805-500-6203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1010651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice