Provider Demographics
NPI:1255063400
Name:SEELBACH, ANN MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:MARIE
Last Name:SEELBACH
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 1:1911 MERMAID LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-6104
Mailing Address - Country:US
Mailing Address - Phone:806-632-7395
Mailing Address - Fax:
Practice Address - Street 1:3891 E LEAGUE CITY PKWY
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-1551
Practice Address - Country:US
Practice Address - Phone:281-557-7747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX387681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice