Provider Demographics
NPI:1821638206
Name:SEITZ, SAMANTHA DIANE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:DIANE
Last Name:SEITZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6342 MARCHAND ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4312
Mailing Address - Country:US
Mailing Address - Phone:772-643-5158
Mailing Address - Fax:
Practice Address - Street 1:2900 SEMINARY DR BLDG E
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3734
Practice Address - Country:US
Practice Address - Phone:724-552-2950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-13
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS041996122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist