Provider Demographics
NPI:1740305770
Name:SEELEY, WAYNE H (DMD)
Entity type:Individual
Prefix:
First Name:WAYNE
Middle Name:H
Last Name:SEELEY
Suffix:
Gender:M
Credentials:DMD
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 317
Mailing Address - Street 2:
Mailing Address - City:FREEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13068-0317
Mailing Address - Country:US
Mailing Address - Phone:607-844-3455
Mailing Address - Fax:607-844-4761
Practice Address - Street 1:2028 DRYDEN RD
Practice Address - Street 2:
Practice Address - City:FREEVILLE
Practice Address - State:NY
Practice Address - Zip Code:13068-0317
Practice Address - Country:US
Practice Address - Phone:607-844-3455
Practice Address - Fax:607-844-4761
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282571223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223G0001XDental ProvidersDentistGeneral Practice
Not Answered1223P0221XDental ProvidersDentistPediatric Dentistry