Provider Demographics
NPI:1407079320
Name:SELLER, HUGH P (DDS)
Entity Type:Individual
Prefix:DR
First Name:HUGH
Middle Name:P
Last Name:SELLER
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 1:105 W 78TH PL
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5468
Mailing Address - Country:US
Mailing Address - Phone:219-736-2368
Mailing Address - Fax:219-736-9867
Practice Address - Street 1:105 W 78TH PL
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5468
Practice Address - Country:US
Practice Address - Phone:219-736-2368
Practice Address - Fax:219-736-9867
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12008033A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice