Provider Demographics
NPI:1700091162
Name:SEEGER, DAVID G (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:SEEGER
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 1:23 SOUTH ASH STREET
Mailing Address - Street 2:PO BOX 1272
Mailing Address - City:OMAK
Mailing Address - State:WA
Mailing Address - Zip Code:98841-1272
Mailing Address - Country:US
Mailing Address - Phone:509-826-1930
Mailing Address - Fax:
Practice Address - Street 1:23 S ASH STREET
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841
Practice Address - Country:US
Practice Address - Phone:509-826-1930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000039961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5373204Medicaid