Provider Demographics
NPI:1376660225
Name:SEITELMAN, LAWRENCE HOWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:HOWARD
Last Name:SEITELMAN
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 1:10 SANDALWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-2700
Mailing Address - Country:US
Mailing Address - Phone:518-371-1104
Mailing Address - Fax:
Practice Address - Street 1:964 ROUTE 146
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3614
Practice Address - Country:US
Practice Address - Phone:518-371-3611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY313551223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics