Provider Demographics
NPI:1457935959
Name:SIEFKER, ABBY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ABBY
Middle Name:
Last Name:SIEFKER
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:PO BOX 250
Mailing Address - Street 2:
Mailing Address - City:OTTOVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45876-0250
Mailing Address - Country:US
Mailing Address - Phone:419-453-3000
Mailing Address - Fax:419-453-3001
Practice Address - Street 1:125 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OTTOVILLE
Practice Address - State:OH
Practice Address - Zip Code:45876-8763
Practice Address - Country:US
Practice Address - Phone:419-453-3000
Practice Address - Fax:419-453-3001
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.026461122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist