Provider Demographics
NPI:1306983754
Name:SEIDLER, STEPHEN B (DDS)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:B
Last Name:SEIDLER
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 1:4942 W STATE ROAD 46
Mailing Address - Street 2:STE 1038
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-9245
Mailing Address - Country:US
Mailing Address - Phone:407-320-1700
Mailing Address - Fax:
Practice Address - Street 1:4942 W STATE ROAD 46
Practice Address - Street 2:STE 1038
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-9245
Practice Address - Country:US
Practice Address - Phone:407-320-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL86131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice