Provider Demographics
NPI:1508021510
Name:SEHEULT, STEPHEN THOMAS ANDREW (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:THOMAS ANDREW
Last Name:SEHEULT
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:PO BOX 2015
Mailing Address - Street 2:211 5TH STREET WEST
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912
Mailing Address - Country:US
Mailing Address - Phone:406-892-4348
Mailing Address - Fax:406-892-4814
Practice Address - Street 1:211 5TH ST W
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-3607
Practice Address - Country:US
Practice Address - Phone:406-892-4348
Practice Address - Fax:406-892-4814
Is Sole Proprietor?:No
Enumeration Date:2008-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57305122300000X
MT13301122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist