Provider Demographics
NPI:1255543286
Name:SEILER, STEPHEN G (DDS)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:G
Last Name:SEILER
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 1:1580 E CHEYENNE MOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4007
Mailing Address - Country:US
Mailing Address - Phone:719-576-4247
Mailing Address - Fax:719-576-3070
Practice Address - Street 1:1580 E CHEYENNE MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4007
Practice Address - Country:US
Practice Address - Phone:719-576-4247
Practice Address - Fax:719-576-3070
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1040341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice