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Organization

NORTHERN QUALITY DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BENJAMIN JARVIS SEYMOUR D.D.S. (DENTIST)
(231) 775-6531
Entity
Organization

Contact information

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

Taxonomy

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

Other

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
Enumeration date
06/11/2009
Last updated
06/11/2009
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