Provider Demographics
NPI:1467518357
Name:WAYNE J SELTING DDS
Entity Type:Organization
Organization Name:WAYNE J SELTING DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SELTING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:719-593-1177
Mailing Address - Street 1:2918 AUSTIN BLUFFS PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-5772
Mailing Address - Country:US
Mailing Address - Phone:719-593-1177
Mailing Address - Fax:719-531-0043
Practice Address - Street 1:2918 AUSTIN BLUFFS PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5772
Practice Address - Country:US
Practice Address - Phone:719-593-1177
Practice Address - Fax:719-531-0043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1044121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty