MEDICARE: DR. HARVEY E MATHENY D.D.S.,M.S.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics	2478	TN

General Provider Information

NPI Number	:	1134340219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARVEY E MATHENY D.D.S.,M.S.D.

Provider Business Mailing Address
First Line	:	7865 EDUCATORS LN
Second Line	:	STE. #120
City	:	MEMPHIS
State	:	TN
Zip	:	38133-8191
Country	:	US
Telephone Number	:	901-380-7994
Fax Number	:	901-380-7995

Provider Business Practice Location Address
First Line	:	7865 EDUCATORS LN
Second Line	:	STE. #120
City	:	MEMPHIS
State	:	TN
Zip	:	38133-8191
Country	:	US
Telephone Number	:	901-380-7994
Fax Number	:	901-380-7995

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	04/15/2013

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