Provider Demographics
NPI:1144282872
Name:SEIP, MICHAEL J (DDS)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:SEIP
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 1:1061 STATE ROUTE 260
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:88632-4624
Mailing Address - Country:US
Mailing Address - Phone:928-699-7347
Mailing Address - Fax:
Practice Address - Street 1:1061 STATE ROUTE 260
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4246
Practice Address - Country:US
Practice Address - Phone:928-478-8447
Practice Address - Fax:928-474-8447
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD05238122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist