Provider Demographics
NPI:1619151461
Name:SEBOK, KRISZTINA
Entity Type:Individual
Prefix:
First Name:KRISZTINA
Middle Name:
Last Name:SEBOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FOX HALL RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-2044
Mailing Address - Country:US
Mailing Address - Phone:207-878-6797
Mailing Address - Fax:
Practice Address - Street 1:10 FOX HALL RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-2044
Practice Address - Country:US
Practice Address - Phone:207-878-6797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME35701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice