Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | D13278 | MN |
NPI | 1003255589 |
---|---|
Provider Name | Dr. Samantha Kaye Seys |
First Address | Mankato, MN 56001-0438 |
Second Address | Mankato, MN 56001-0438 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2013 |
Last Update Date | 18/06/2013 |