Provider Demographics
NPI:1699935213
Name:SEITA, CHARLES LOUIS (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:LOUIS
Last Name:SEITA
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 GRAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26105-4049
Mailing Address - Country:US
Mailing Address - Phone:304-422-6477
Mailing Address - Fax:
Practice Address - Street 1:907 51ST ST
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:WV
Practice Address - Zip Code:26105-3141
Practice Address - Country:US
Practice Address - Phone:304-295-6527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV19311223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics