Provider Demographics
NPI:1871755512
Name:SETZER, BARRY PHILIP (DDS)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:PHILIP
Last Name:SETZER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8355 BAYBERRY RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-4427
Mailing Address - Country:US
Mailing Address - Phone:904-733-7254
Mailing Address - Fax:904-731-0144
Practice Address - Street 1:8355 BAYBERRY RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-4427
Practice Address - Country:US
Practice Address - Phone:904-733-7254
Practice Address - Fax:904-731-0144
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN61381223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL86443OtherBLUE CROSS BLUE SHIELD
FL145327OtherUNITED CONCORDIA
GA00419295AMedicaid
FL076337300Medicaid