Provider Demographics
NPI:1316508690
Name:HERR, MARISOL ANN SEYS (DDS)
Entity type:Individual
Prefix:DR
First Name:MARISOL
Middle Name:ANN SEYS
Last Name:HERR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MARISOL
Other - Middle Name:ANN
Other - Last Name:SEYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:515 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:49252-9145
Mailing Address - Country:US
Mailing Address - Phone:319-883-9214
Mailing Address - Fax:517-235-2806
Practice Address - Street 1:515 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:MI
Practice Address - Zip Code:49252-9145
Practice Address - Country:US
Practice Address - Phone:517-542-2941
Practice Address - Fax:517-325-2806
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901023164122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist