Provider Demographics
NPI:1417939166
Name:SEYMOUR, DOUGLAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:
Last Name:SEYMOUR
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 1:10001 AURORA AVE N
Mailing Address - Street 2:SUITE 14
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9328
Mailing Address - Country:US
Mailing Address - Phone:206-363-4300
Mailing Address - Fax:
Practice Address - Street 1:10001 AURORA AVE N
Practice Address - Street 2:SUITE 14
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9328
Practice Address - Country:US
Practice Address - Phone:206-363-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA66131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice