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General NPI Number Information
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NPI Number | 1376858597
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Entity Type | Individual
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Provider Name | MATTHEW GUY SETLIFF D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 4881 SUGAR MAPLE DR
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City | WPAFB
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State | OH
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Zip | 45433-5546
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Country | US
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Telephone | 724-875-7317
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Fax |
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Provider Business Mailing Address
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Address Line | 3135 COURT VIEW DR APT 5
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City | BEAVERCREEK
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State | OH
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Zip | 45431-8826
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Country | US
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Telephone | 724-875-7317
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS038404
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License Number State | PA
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