Provider Demographics
NPI:1972865624
Name:BEGUR SESHADRI, SATHVIK
Entity Type:Individual
Prefix:
First Name:SATHVIK
Middle Name:
Last Name:BEGUR SESHADRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 SANFORD RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-4038
Mailing Address - Country:US
Mailing Address - Phone:508-675-0561
Mailing Address - Fax:
Practice Address - Street 1:708 SANFORD RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:MA
Practice Address - Zip Code:02790-4038
Practice Address - Country:US
Practice Address - Phone:508-675-0561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856007122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist