Healthcare Provider Details

I. General information

NPI: 1255599700
Provider Name (Legal Business Name): MATTHEW DAVID ARNALL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 04/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 N 110TH ST
MESA AZ
85207-2234
US

IV. Provider business mailing address

716 N 110TH ST
MESA AZ
85207-2234
US

V. Phone/Fax

Practice location:
  • Phone: 928-848-2596
  • Fax:
Mailing address:
  • Phone: 928-848-2596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD4135
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number057826-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD008161
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License NumberD008161
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: