Organization
SEUBERT & OMLIE DDS PLLC
Active
Other names
Cosmetic, Family & Sports Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHASE SEUBERT DDS (CEO/DENTIST)
(952) 922-9119
Entity
Organization
Contact information
Practice address
6545 FRANCE AVE S STE 585, EDINA, MN 55435-2125
(952) 922-9119
Mailing address
6545 FRANCE AVE S STE 585, EDINA, MN 55435-2125
(952) 922-9119
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104278217
INDIVIDUAL
—
01
—
1639579329
INDIVIDUAL
—
Enumeration date
11/17/2021
Last updated
11/17/2021
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