Provider Demographics
NPI:1801017017
Name:SEIBERT, THOMAS J (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:SEIBERT
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 1:919 CONESTOGA RD
Mailing Address - Street 2:BUILDING TWO - SUITE 209
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1352
Mailing Address - Country:US
Mailing Address - Phone:484-380-2143
Mailing Address - Fax:
Practice Address - Street 1:919 CONESTOGA RD
Practice Address - Street 2:BUILDING TWO - SUITE 209
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1352
Practice Address - Country:US
Practice Address - Phone:484-380-2143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025576-L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics