Provider Demographics
NPI:1952490484
Name:SEIDER & STEVENS PA
Entity Type:Organization
Organization Name:SEIDER & STEVENS PA
Other - Org Name:BROWARD ORAL SURGERY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SEC TREAS
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-966-7100
Mailing Address - Street 1:3157 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024
Mailing Address - Country:US
Mailing Address - Phone:954-431-1600
Mailing Address - Fax:954-432-7994
Practice Address - Street 1:3157 N UNIVERSITY DR
Practice Address - Street 2:SUITE 104
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024
Practice Address - Country:US
Practice Address - Phone:954-431-1600
Practice Address - Fax:954-432-7994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery