Provider Demographics
NPI:1659052173
Name:SCHILHABEL, SETH (DMD)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:SCHILHABEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 FOREST GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-5757
Mailing Address - Country:US
Mailing Address - Phone:661-809-4226
Mailing Address - Fax:
Practice Address - Street 1:700 MCHUGH BLVD
Practice Address - Street 2:BLDG HP 102
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28547
Practice Address - Country:US
Practice Address - Phone:661-809-4226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13451270-9921122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist