Individual
DR. WILLIAM COLLIN SEALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1430 W MCNEESE ST, LAKE CHARLES, LA 70605-4240
(337) 474-0212
Mailing address
1430 W MCNEESE ST, LAKE CHARLES, LA 70605-4240
(337) 474-0212
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7079
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7079
LOUISIANA BOARD OF DENTISTRY
LA
Enumeration date
06/05/2020
Last updated
06/05/2020
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