Provider Demographics
NPI:1689767428
Name:MICHAEL P. SEIDMAN
Entity Type:Organization
Organization Name:MICHAEL P. SEIDMAN
Other - Org Name:DENTAL ASSOCIATES OF CAPE COD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:SEIDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-778-1200
Mailing Address - Street 1:262 BARNSTABLE RD
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-2919
Mailing Address - Country:US
Mailing Address - Phone:508-778-1200
Mailing Address - Fax:508-775-5502
Practice Address - Street 1:262 BARNSTABLE RD
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-2919
Practice Address - Country:US
Practice Address - Phone:508-778-1200
Practice Address - Fax:508-775-5502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA163151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA25259OtherUNITED CONCORDIA
MA380021OtherHARVARD PILGRIM HEALTH
MAX10615OtherBLUE CROSS/BLUE SHIELD