# DR. BENJAMIN JARVIS SEYMOUR

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1003981002
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 29010-19403 | MI | Yes |

## Other

- **Enumeration date:** 11/22/2006
- **Last updated:** 07/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1883242 | UNITED CONCORDIA | MI |
| 01 | — | 4918174 | MEDICAID | MI |
| 01 | — | 4919500 | MEDICAID | MI |
| 01 | — | 4919510 | MEDICAID | MI |
| 01 | — | D194030 | BCBS | MI |