Provider Demographics
NPI:1932561040
Name:SEIBEL SPYROU LLC
Entity Type:Organization
Organization Name:SEIBEL SPYROU LLC
Other - Org Name:PEDIATRIC DENTISTRY AND ORTHODONTICS OF SUDBURY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:987-443-5431
Mailing Address - Street 1:410 BOSTON POST RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-3058
Mailing Address - Country:US
Mailing Address - Phone:987-443-5431
Mailing Address - Fax:987-443-5465
Practice Address - Street 1:410 BOSTON POST RD
Practice Address - Street 2:SUITE 6
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-3058
Practice Address - Country:US
Practice Address - Phone:987-443-5431
Practice Address - Fax:987-443-5465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty