Provider Demographics
NPI:1013100213
Name:SEITZ, EILEEN CONWAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:CONWAY
Last Name:SEITZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 GALLERIA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6185
Mailing Address - Country:US
Mailing Address - Phone:615-771-7733
Mailing Address - Fax:615-771-7766
Practice Address - Street 1:1745 GALLERIA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6185
Practice Address - Country:US
Practice Address - Phone:615-771-7733
Practice Address - Fax:615-771-7766
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000070721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice