Provider Demographics
NPI:1528163631
Name:SEYMOUR, BRITTANY (DDS, MPH)
Entity type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 LONGWOOD AVE
Mailing Address - Street 2:REB 204
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5819
Mailing Address - Country:US
Mailing Address - Phone:617-432-1848
Mailing Address - Fax:617-432-0047
Practice Address - Street 1:188 LONGWOOD AVE
Practice Address - Street 2:REB 204
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5819
Practice Address - Country:US
Practice Address - Phone:617-432-1848
Practice Address - Fax:617-432-0047
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO89801223G0001X
MADN1855779122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist