Provider Demographics
NPI:1942757075
Name:SHREYER, TETYANA (DMD)
Entity Type:Individual
Prefix:DR
First Name:TETYANA
Middle Name:
Last Name:SHREYER
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 1:6 MEADOWLARK LN
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-1533
Mailing Address - Country:US
Mailing Address - Phone:857-222-0704
Mailing Address - Fax:
Practice Address - Street 1:6 MEADOWLARK LN
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-1533
Practice Address - Country:US
Practice Address - Phone:857-222-0704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1857427122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist