Provider Demographics
NPI:1700843547
Name:SEALS, TECKOLAR
Entity Type:Individual
Prefix:MRS
First Name:TECKOLAR
Middle Name:
Last Name:SEALS
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 1:7408 ALBATROSS CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4758
Mailing Address - Country:US
Mailing Address - Phone:240-355-9687
Mailing Address - Fax:
Practice Address - Street 1:1530 GILBERT ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23511-2730
Practice Address - Country:US
Practice Address - Phone:757-444-1003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist