Provider Demographics
NPI:1669676573
Name:THURMAN, SEABORN MICHAEL (DMD)
Entity Type:Individual
Prefix:
First Name:SEABORN
Middle Name:MICHAEL
Last Name:THURMAN
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 1:1203 TWO ISLAND CT UNIT 101
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7405
Mailing Address - Country:US
Mailing Address - Phone:843-884-6166
Mailing Address - Fax:843-884-1140
Practice Address - Street 1:1203 TWO ISLAND CT UNIT 101
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7405
Practice Address - Country:US
Practice Address - Phone:843-884-6166
Practice Address - Fax:843-884-1140
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1834122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist