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NPI Code Detail

MEDICARE: DR. DAVID N. MATTHEWS DDS MS

MEDICARE:  DR. DAVID N. MATTHEWS  DDS MS
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 Dentistry7802IN

General Provider Information

NPI Number : 1396844114
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID N. MATTHEWS DDS MS
Provider Business Mailing Address
First Line : 3611 BROADWAY
Second Line :
City : FORT WAYNE
State : IN
Zip : 46807-1724
Country : US
Telephone Number : 260-456-3406
Fax Number : 260-456-3055
Provider Business Practice Location Address
First Line : 3611 BROADWAY
Second Line :
City : FORT WAYNE
State : IN
Zip : 46807-1724
Country : US
Telephone Number : 260-456-3406
Fax Number : 260-456-3055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 07/08/2007

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Directions to “ DR. DAVID N. MATTHEWS DDS MS” Practice Location

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