Provider Demographics
NPI:1366579294
Name:SEESE, BRIAN TIMOTHY (DMD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:TIMOTHY
Last Name:SEESE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 JETTON ST STE 250
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-9323
Mailing Address - Country:US
Mailing Address - Phone:704-895-5095
Mailing Address - Fax:704-895-5097
Practice Address - Street 1:610 JETTON ST STE 250
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-9323
Practice Address - Country:US
Practice Address - Phone:704-895-5095
Practice Address - Fax:704-895-5097
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC78041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice