Provider Demographics
NPI:1700968450
Name:WILLIAM A. SEPER, D.D.S., P.C.
Entity type:Organization
Organization Name:WILLIAM A. SEPER, D.D.S., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:SEPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-403-0100
Mailing Address - Street 1:9661 W 143RD ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-2088
Mailing Address - Country:US
Mailing Address - Phone:708-403-0100
Mailing Address - Fax:708-403-8657
Practice Address - Street 1:9661 W 143RD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-2088
Practice Address - Country:US
Practice Address - Phone:708-403-0100
Practice Address - Fax:708-403-8657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty