Provider Demographics
NPI:1518598069
Name:SEAWAY DENTAL GROUP PLLC
Entity Type:Organization
Organization Name:SEAWAY DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:GUASS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-982-5334
Mailing Address - Street 1:2435 MILITARY ST BLDG 4
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-6664
Mailing Address - Country:US
Mailing Address - Phone:810-982-5334
Mailing Address - Fax:
Practice Address - Street 1:2435 MILITARY ST BLDG 4
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-6664
Practice Address - Country:US
Practice Address - Phone:810-982-5334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty