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NPI Code Detail

MEDICARE: DR. MATTHEW JOHN SKURICH DDS

MEDICARE: DR. MATTHEW JOHN SKURICH DDS
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
1122300000XDentist30.022086OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336249895
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW JOHN SKURICH DDS
Provider Business Mailing Address
First Line : 726 WICK AVE
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44505-2827
Country : US
Telephone Number : 330-757-8066
Fax Number : 330-884-6120
Provider Business Practice Location Address
First Line : 716 TOD AVE SW
Second Line :
City : WARREN
State : OH
Zip : 44485-3608
Country : US
Telephone Number : 330-373-0222
Fax Number : 330-884-6120
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 07/26/2016

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