Provider Demographics
NPI:1417059866
Name:SEIDLER, KEVIN LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:LEE
Last Name:SEIDLER
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 1:6600 PAIGE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056
Mailing Address - Country:US
Mailing Address - Phone:972-370-2125
Mailing Address - Fax:972-625-2132
Practice Address - Street 1:6600 PAIGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056
Practice Address - Country:US
Practice Address - Phone:972-370-2125
Practice Address - Fax:972-625-2132
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice