Provider Demographics
NPI:1316194228
Name:SHETH, BHAVIT (DMD)
Entity Type:Individual
Prefix:DR
First Name:BHAVIT
Middle Name:
Last Name:SHETH
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 1:168 WILLIAM L. DALTON DRIVE
Mailing Address - Street 2:GLASSBORO DENTISTRY L.L.C
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028
Mailing Address - Country:US
Mailing Address - Phone:856-956-3625
Mailing Address - Fax:856-956-3619
Practice Address - Street 1:168 WILLIAM L. DALTON DRIVE
Practice Address - Street 2:GLASSBORO DENTISTRY LLC
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028
Practice Address - Country:US
Practice Address - Phone:856-956-3625
Practice Address - Fax:856-956-3619
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI0238791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice