Provider Demographics
NPI:1528108685
Name:SEU, RUI SERGIO (DDS)
Entity type:Individual
Prefix:
First Name:RUI
Middle Name:SERGIO
Last Name:SEU
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 1:40 POSSUM WAY
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-1214
Mailing Address - Country:US
Mailing Address - Phone:908-898-1411
Mailing Address - Fax:
Practice Address - Street 1:924 SOUTH AVE W
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090
Practice Address - Country:US
Practice Address - Phone:908-789-2220
Practice Address - Fax:908-789-1232
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI20795122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist