Healthcare Provider Details

I. General information

NPI: 1306960703
Provider Name (Legal Business Name): MATHEW DAVID FINKELSON DMD., MMSC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 NEW RD
NORTHFIELD NJ
08225-1409
US

IV. Provider business mailing address

19 GEORGETOWN CT
LINWOOD NJ
08221-1560
US

V. Phone/Fax

Practice location:
  • Phone: 609-645-1559
  • Fax: 609-645-0099
Mailing address:
  • Phone: 609-927-1084
  • Fax: 609-653-9071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number13925
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: