Provider Demographics
NPI:1477726321
Name:JOHN H. SEIFERT DMD PC
Entity Type:Organization
Organization Name:JOHN H. SEIFERT DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFIE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:S
Authorized Official - Last Name:NEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-585-4281
Mailing Address - Street 1:2605 12TH PL SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-2576
Mailing Address - Country:US
Mailing Address - Phone:503-585-4281
Mailing Address - Fax:503-585-7427
Practice Address - Street 1:2605 12TH PL SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-2576
Practice Address - Country:US
Practice Address - Phone:503-585-4281
Practice Address - Fax:503-585-7427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6248261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental