Provider Demographics
NPI:1457594434
Name:SELZER, MICHAEL DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAVID
Last Name:SELZER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8177 W. GLADES RD
Mailing Address - Street 2:SUITE 23
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434
Mailing Address - Country:US
Mailing Address - Phone:561-487-4555
Mailing Address - Fax:561-487-5251
Practice Address - Street 1:8177 W. GLADES RD
Practice Address - Street 2:SUITE 23
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434
Practice Address - Country:US
Practice Address - Phone:561-487-4555
Practice Address - Fax:561-487-5251
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL74171223G0001X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0700XDental ProvidersDentistProsthodontics