Provider Demographics
NPI:1972956571
Name:CHAD R SEABOLD DDS MD
Entity type:Organization
Organization Name:CHAD R SEABOLD DDS MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:R
Authorized Official - Last Name:SEABOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MD
Authorized Official - Phone:713-981-0000
Mailing Address - Street 1:4550 POST OAK PLACE DR STE 160
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3127
Mailing Address - Country:US
Mailing Address - Phone:713-981-0000
Mailing Address - Fax:
Practice Address - Street 1:4550 POST OAK PLACE DR STE 160
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3127
Practice Address - Country:US
Practice Address - Phone:713-981-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX287781223S0112X
TX241831223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty