Healthcare Provider Details

I. General information

NPI: 1922100932
Provider Name (Legal Business Name): MATTHEW CAUSEY D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 06/16/2021
Certification Date: 06/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 MACGREGOR DOWNS RD
GREENVILLE NC
27834-5925
US

IV. Provider business mailing address

3809 KENDELE CT
BURLINGTON NC
27215-8072
US

V. Phone/Fax

Practice location:
  • Phone: 252-737-7199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8052
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: