# NORTHERN QUALITY DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144457672
- **Authorized official:** DR. BENJAMIN JARVIS SEYMOUR D.D.S. (DENTIST)
- **Authorized official phone:** (231) 775-6531

## Contact information

- **Practice address:** 504 HAYNES ST, CADILLAC, MI 49601-1809
- **Practice address phone:** (231) 775-6531
- **Practice address fax:** (231) 775-6431
- **Mailing address:** 504 HAYNES ST, CADILLAC, MI 49601-1809
- **Mailing address phone:** (231) 775-6531
- **Mailing address fax:** (231) 775-6431

## Taxonomy

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

## Other

- **Enumeration date:** 06/11/2009
- **Last updated:** 06/11/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1883238 | UNITED CONCORDIA | MI |
| 01 | — | 1883242 | UNITED CONCORDIA | MI |
| 05 | — | 4918174 | — | MI |
| 05 | — | 4918183 | — | MI |
| 05 | — | 4919485 | — | MI |
| 05 | — | 4919494 | — | MI |
| 05 | — | 4919500 | — | MI |
| 05 | — | 4919510 | — | MI |
| 01 | — | D194030 | BCBS | MI |
| 01 | — | D194040 | BCBS | MI |