Provider Demographics
NPI:1538699707
Name:STEPHEN TA SEHEULT DDS
Entity Type:Organization
Organization Name:STEPHEN TA SEHEULT DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:TA
Authorized Official - Last Name:SEHEULT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:406-892-4348
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT13301261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental