Provider Demographics
NPI:1306884044
Name:SEEGER, DOUGLAS H (DMD MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:H
Last Name:SEEGER
Suffix:
Gender:M
Credentials:DMD MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:992 MANTUA PIKE
Mailing Address - Street 2:SUITE 302 WESTWOOD ORAL SURGERY ASSOCIATES PA
Mailing Address - City:WOODBURY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08097
Mailing Address - Country:US
Mailing Address - Phone:856-845-1341
Mailing Address - Fax:856-384-9067
Practice Address - Street 1:992 MANTUA PIKE
Practice Address - Street 2:SUITE 302 WESTWOOD ORAL SURGERY ASSOCIATES PA
Practice Address - City:WOODBURY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08097
Practice Address - Country:US
Practice Address - Phone:856-845-1341
Practice Address - Fax:856-384-9067
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1023146001223S0112X
PADS031358L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
102333 ATLOtherPTAN
NJ23146/0925OtherDELTA
2749374000OtherAMERIHEALTH MANAGED CARE
2749374000OtherAMERIHEALTH MANAGED CARE
102333Medicare PIN