Provider Demographics
NPI:1629523865
Name:CHOKSI, SETU (DMD)
Entity Type:Individual
Prefix:
First Name:SETU
Middle Name:
Last Name:CHOKSI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 MASSACHUSETTS AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-4047
Mailing Address - Country:US
Mailing Address - Phone:781-884-8211
Mailing Address - Fax:
Practice Address - Street 1:65 DRUM HILL RD
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1503
Practice Address - Country:US
Practice Address - Phone:978-770-2308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1857363122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist