Healthcare Provider Details

I. General information

NPI: 1942038328
Provider Name (Legal Business Name): MATTHEW R. KANTER, DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2024
Last Update Date: 07/25/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25460 MEDICAL CENTER DR STE 204
MURRIETA CA
92562-5985
US

IV. Provider business mailing address

25460 MEDICAL CENTER DR STE 204
MURRIETA CA
92562-5985
US

V. Phone/Fax

Practice location:
  • Phone: 951-677-7785
  • Fax:
Mailing address:
  • Phone: 951-677-7785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW RANDALL KANTER
Title or Position: PRESIDENT/OWNER
Credential: D.D.S.
Phone: 951-677-7785