Provider Demographics
NPI:1346778776
Name:SETAPUTRI, ZANE ROBERT (DDS)
Entity Type:Individual
Prefix:
First Name:ZANE
Middle Name:ROBERT
Last Name:SETAPUTRI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3397 CAMROSE DR
Mailing Address - Street 2:
Mailing Address - City:HUDSONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49426-8821
Mailing Address - Country:US
Mailing Address - Phone:313-574-4833
Mailing Address - Fax:
Practice Address - Street 1:3397 CAMROSE DR
Practice Address - Street 2:
Practice Address - City:HUDSONVILLE
Practice Address - State:MI
Practice Address - Zip Code:49426-8821
Practice Address - Country:US
Practice Address - Phone:313-574-4833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010222671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice