Provider Demographics
NPI:1689297327
Name:SEAGER, MOEZA A
Entity Type:Individual
Prefix:
First Name:MOEZA
Middle Name:A
Last Name:SEAGER
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 1:2604 OLD DENTON RD STE 112
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5137
Mailing Address - Country:US
Mailing Address - Phone:927-323-5060
Mailing Address - Fax:724-632-6312
Practice Address - Street 1:2604 OLD DENTON RD STE 112
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5137
Practice Address - Country:US
Practice Address - Phone:927-323-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX389961223G0001X
PADS0427921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice