Provider Demographics
NPI:1881891349
Name:SEALE, JOHN JOSHUA (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSHUA
Last Name:SEALE
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:PO BOX 5210
Mailing Address - Street 2:
Mailing Address - City:SAM RAYBURN
Mailing Address - State:TX
Mailing Address - Zip Code:75951
Mailing Address - Country:US
Mailing Address - Phone:409-698-8800
Mailing Address - Fax:409-698-8801
Practice Address - Street 1:3303 RR 255 WEST
Practice Address - Street 2:
Practice Address - City:BROOKELAND
Practice Address - State:TX
Practice Address - Zip Code:75931
Practice Address - Country:US
Practice Address - Phone:409-698-8800
Practice Address - Fax:409-698-8801
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22917122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist