Provider Demographics
NPI:1144356601
Name:SETAYESH, M REZA (DMD)
Entity type:Individual
Prefix:
First Name:M REZA
Middle Name:
Last Name:SETAYESH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:884 WASHINGTON STREET
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-1530
Mailing Address - Country:US
Mailing Address - Phone:781-340-5362
Mailing Address - Fax:781-340-3993
Practice Address - Street 1:884 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-1530
Practice Address - Country:US
Practice Address - Phone:781-340-5362
Practice Address - Fax:781-340-3993
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAD 153041223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics