Provider Demographics
NPI:1740660661
Name:SEETNER, JORDAN (DMD)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:
Last Name:SEETNER
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 1:76 W CEDAR ST
Mailing Address - Street 2:APT 5R
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-3326
Mailing Address - Country:US
Mailing Address - Phone:610-324-1001
Mailing Address - Fax:
Practice Address - Street 1:1 KNEELAND ST
Practice Address - Street 2:TUFTS SCHOOL OF DENTAL MEDICINE, DEP OF ORTHODONTICS
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:610-324-1001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program