Provider Demographics
NPI:1053715417
Name:SEEBINGER, MICHELLE (RDH)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SEEBINGER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:MCGWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9630B GUADALUPE TRL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-2005
Mailing Address - Country:US
Mailing Address - Phone:505-261-9923
Mailing Address - Fax:
Practice Address - Street 1:6349 HWY 550
Practice Address - Street 2:
Practice Address - City:CUBA
Practice Address - State:NM
Practice Address - Zip Code:87013
Practice Address - Country:US
Practice Address - Phone:505-261-9923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDH516124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist