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General NPI Number Information
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NPI Number | 1003947185
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Entity Type | Organization
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Legal Business Name | MATTHEW W. NAKFOOR, DDS, PC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 203 W MICHIGAN AVE #204
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City | SALINE
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State | MI
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Zip | 48176-1329
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Country | US
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Telephone | 734-429-3850
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Fax | 734-429-0502
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Provider Business Mailing Address
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Address Line | 203 W MICHIGAN AVE #204
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City | SALINE
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State | MI
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Zip | 48176-1329
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Country | US
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Telephone | 734-429-3850
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Fax | 734-429-0502
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW W NAKFOOR
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Credential | DDS
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Telephone | 734-429-3850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 18794
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 30.022260
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 30.022259
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 18343
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License Number State | MI
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