Provider Demographics
NPI:1518390756
Name:RESTORATIVE AND AESTHETIC DENTISTRY
Entity Type:Organization
Organization Name:RESTORATIVE AND AESTHETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:SEAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,MS
Authorized Official - Phone:719-593-0005
Mailing Address - Street 1:5725 ERINDALE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-1984
Mailing Address - Country:US
Mailing Address - Phone:719-593-0005
Mailing Address - Fax:719-593-0282
Practice Address - Street 1:5725 ERINDALE DR STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1984
Practice Address - Country:US
Practice Address - Phone:719-593-0005
Practice Address - Fax:719-593-0282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO60601223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty