MEDICARE: MATTHEW P. MCMASTERS,DDS,PC

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	122300000X	Dentist	DS00007865	TN

General Provider Information

NPI Number	:	1801068119
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATTHEW P. MCMASTERS,DDS,PC

Provider Business Mailing Address
First Line	:	26741 MAIN ST
Second Line	:	PO BOX 488
City	:	ARDMORE
State	:	TN
Zip	:	38449-3120
Country	:	US
Telephone Number	:	931-427-2116
Fax Number	:	931-427-8290

Provider Business Practice Location Address
First Line	:	26741 MAIN ST
Second Line	:	26741 MAIN STREET
City	:	ARDMORE
State	:	TN
Zip	:	38449-3120
Country	:	US
Telephone Number	:	931-427-2116
Fax Number	:	931-427-8290

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MATTHEW PATRICK MCMASTERS
Credential	:	DDS
Telephone Number	:	931-427-2116

Provider Enumeration Date	:	03/26/2008
Last Update Date	:	03/25/2014

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