Provider Demographics
NPI:1285752766
Name:DINES, TEVYAH J (DMD, MMSC)
Entity type:Individual
Prefix:DR
First Name:TEVYAH
Middle Name:J
Last Name:DINES
Suffix:
Gender:M
Credentials:DMD, MMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 LEEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-2335
Mailing Address - Country:US
Mailing Address - Phone:781-983-1806
Mailing Address - Fax:
Practice Address - Street 1:35 LEEWOOD RD
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-2335
Practice Address - Country:US
Practice Address - Phone:781-983-1806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA190141223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics