Provider Demographics
NPI:1013134360
Name:SELDEN, JOHN N (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:N
Last Name:SELDEN
Suffix:
Gender:M
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:P.O. BOX 988
Mailing Address - Street 2:
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611
Mailing Address - Country:US
Mailing Address - Phone:907-335-7500
Mailing Address - Fax:888-491-3360
Practice Address - Street 1:508 UPLAND STREET
Practice Address - Street 2:
Practice Address - City:KENAI
Practice Address - State:AK
Practice Address - Zip Code:99611
Practice Address - Country:US
Practice Address - Phone:907-335-7500
Practice Address - Fax:888-491-3360
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK8771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice