Provider Demographics
NPI:1639287170
Name:ERIC V SESSELMANN DDS PC
Entity Type:Organization
Organization Name:ERIC V SESSELMANN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:VEIT
Authorized Official - Last Name:SESSELMANN
Authorized Official - Suffix:SR
Authorized Official - Credentials:DDS
Authorized Official - Phone:231-798-3431
Mailing Address - Street 1:4382 HENRY STREET
Mailing Address - Street 2:
Mailing Address - City:MUSKAGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441
Mailing Address - Country:US
Mailing Address - Phone:231-798-3431
Mailing Address - Fax:231-798-3980
Practice Address - Street 1:4382 HENRY STREET
Practice Address - Street 2:
Practice Address - City:MUSKAGON
Practice Address - State:MI
Practice Address - Zip Code:49441
Practice Address - Country:US
Practice Address - Phone:231-798-3431
Practice Address - Fax:231-798-3980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI132421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty