Provider Demographics
NPI:1700917606
Name:SEIDLER, DARYL JAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARYL
Middle Name:JAY
Last Name:SEIDLER
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 1:223 E FM 1382 STE 104
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2129
Mailing Address - Country:US
Mailing Address - Phone:972-291-9393
Mailing Address - Fax:972-291-3237
Practice Address - Street 1:223 E FM 1382 STE 104
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2129
Practice Address - Country:US
Practice Address - Phone:972-291-9393
Practice Address - Fax:972-291-3237
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX155341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice