Provider Demographics
NPI:1467718403
Name:SEIBEL, KRISTINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:
Last Name:SEIBEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 BOSTON POST RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-3058
Mailing Address - Country:US
Mailing Address - Phone:987-443-5431
Mailing Address - Fax:978-443-5465
Practice Address - Street 1:410 BOSTON POST RD
Practice Address - Street 2:SUITE 6
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-3058
Practice Address - Country:US
Practice Address - Phone:987-443-5431
Practice Address - Fax:978-443-5465
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN195151223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry