Provider Demographics
NPI:1124198908
Name:SELIGMAN, DARIN DALE (DDS)
Entity type:Individual
Prefix:DR
First Name:DARIN
Middle Name:DALE
Last Name:SELIGMAN
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 477
Mailing Address - Street 2:1701 WEST N STREET
Mailing Address - City:MCCOOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-0477
Mailing Address - Country:US
Mailing Address - Phone:308-345-3410
Mailing Address - Fax:
Practice Address - Street 1:1701 W N ST
Practice Address - Street 2:
Practice Address - City:MCCOOK
Practice Address - State:NE
Practice Address - Zip Code:69001-4222
Practice Address - Country:US
Practice Address - Phone:308-345-3410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE59591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE470782100-00Medicaid