Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DS020210L | PA |
NPI | 1083784268 |
---|---|
Provider Name | Dr. David W. Selvig |
First Address | Natrona Heights, PA 15065-2138 |
Second Address | Natrona Heights, PA 15065-2138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |