Provider Demographics
NPI:1891797916
Name:SEIDMAN, IRWIN M (DDS)
Entity Type:Individual
Prefix:
First Name:IRWIN
Middle Name:M
Last Name:SEIDMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:600 N NORTH CT
Mailing Address - Street 2:STE 250
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-8128
Mailing Address - Country:US
Mailing Address - Phone:847-991-4663
Mailing Address - Fax:847-991-4693
Practice Address - Street 1:600 N NORTH CT
Practice Address - Street 2:STE 250
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-8128
Practice Address - Country:US
Practice Address - Phone:847-991-4663
Practice Address - Fax:847-991-4693
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry