Provider Demographics
NPI:1427655828
Name:DR. JOHN T. SEAGO
Entity type:Organization
Organization Name:DR. JOHN T. SEAGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-774-3400
Mailing Address - Street 1:30207 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48082-2612
Mailing Address - Country:US
Mailing Address - Phone:586-774-3400
Mailing Address - Fax:586-774-6615
Practice Address - Street 1:30207 HARPER AVE
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48082-2612
Practice Address - Country:US
Practice Address - Phone:586-774-3400
Practice Address - Fax:586-774-6615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental