Provider Demographics
NPI:1134258841
Name:SEELYE, LES R (DDS)
Entity type:Individual
Prefix:
First Name:LES
Middle Name:R
Last Name:SEELYE
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 1:2075 BARKLEY BOULEVARD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226
Mailing Address - Country:US
Mailing Address - Phone:360-733-8150
Mailing Address - Fax:360-733-8253
Practice Address - Street 1:2075 BARKLEY BOULEVARD
Practice Address - Street 2:SUITE 260
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226
Practice Address - Country:US
Practice Address - Phone:360-733-8150
Practice Address - Fax:360-733-8253
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000077241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice