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NPI Code Detail

MEDICARE: DR. MATTHEW DOUGLAS RILEY DMD

MEDICARE:  DR. MATTHEW DOUGLAS RILEY  DMD
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
11223G0001XGeneral Practice Dentistry9775KY

General Provider Information

NPI Number : 1346698206
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW DOUGLAS RILEY DMD
Provider Business Mailing Address
First Line : 101 STATE AVE
Second Line :
City : GLASGOW
State : KY
Zip : 42141-1448
Country : US
Telephone Number : 270-651-5939
Fax Number :
Provider Business Practice Location Address
First Line : 101 STATE AVE
Second Line :
City : GLASGOW
State : KY
Zip : 42141-1448
Country : US
Telephone Number : 270-651-5939
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2016
Last Update Date : 06/01/2016

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Directions to “ DR. MATTHEW DOUGLAS RILEY DMD” Practice Location

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