Individual
DR. ETHAN THOMAS SEGERSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1721 ADMIRAL TAUSSIG BLVD, NORFOLK, VA 23511-2802
(757) 953-9000
Mailing address
1721 ADMIRAL TAUSSIG BLVD, NORFOLK, VA 23511-2802
(757) 953-9000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DDS-10368
IA
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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