Provider Demographics
NPI:1457892341
Name:SEITER FAMILY DENTISTRY, PLLC
Entity type:Organization
Organization Name:SEITER FAMILY DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:SEITER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-470-6468
Mailing Address - Street 1:2445 LANDOVER TRL
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-2628
Mailing Address - Country:US
Mailing Address - Phone:501-470-6468
Mailing Address - Fax:
Practice Address - Street 1:2157 PRINCE ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3737
Practice Address - Country:US
Practice Address - Phone:501-470-6468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4036261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental