Provider Demographics
NPI:1871875039
Name:LORETA SEYMOUR
Entity type:Organization
Organization Name:LORETA SEYMOUR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LORETA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEYMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-568-8898
Mailing Address - Street 1:5002 SUITLAND RD
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746-1263
Mailing Address - Country:US
Mailing Address - Phone:301-568-8898
Mailing Address - Fax:301-568-8904
Practice Address - Street 1:5002 SUITLAND RD
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-1263
Practice Address - Country:US
Practice Address - Phone:301-568-8898
Practice Address - Fax:301-568-8904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty