MEDICARE: VICTORIA L. MATTHEWS, D.D.S., P.A.

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	1223G0001X	General Practice Dentistry	3606	ME

General Provider Information

NPI Number	:	1942534219
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICTORIA L. MATTHEWS, D.D.S., P.A.

Provider Business Mailing Address
First Line	:	PO BOX 996
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-0996
Country	:	US
Telephone Number	:	207-338-6351
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 GRIFFIN ST
Second Line	:
City	:	NORTHPORT
State	:	ME
Zip	:	04849-4445
Country	:	US
Telephone Number	:	207-338-6351
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VICTORIA LYNNE MATTHEWS
Credential	:	D.D.S.
Telephone Number	:	207-338-6351

Provider Enumeration Date	:	09/19/2009
Last Update Date	:	09/19/2009

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