Provider Demographics
NPI:1477756864
Name:SEITZINGER, SCOTT D (DMD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:SEITZINGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3429 LONE OAK RD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-5775
Mailing Address - Country:US
Mailing Address - Phone:270-534-8881
Mailing Address - Fax:270-534-0115
Practice Address - Street 1:3429 LONE OAK RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-5775
Practice Address - Country:US
Practice Address - Phone:270-534-8881
Practice Address - Fax:270-534-0115
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY70971223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6403OtherAAE
KY6403OtherAAE