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General NPI Number Information
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NPI Number | 1083935647
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Entity Type | Individual
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Provider Name | MATHEW P CHERIAN DMD
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Gender | Male
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Dates
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Enumeration Date | 06/17/2010
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Last Update Date | 06/17/2010
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Provider Practice Location Address
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Address Line | 7419 NEW FALLS RD
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City | LEVITTOWN
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State | PA
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Zip | 19055-1008
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Country | US
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Telephone | 267-324-6388
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Fax |
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Provider Business Mailing Address
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Address Line | 10210 GALAHAD RD
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City | PHILADELPHIA
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State | PA
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Zip | 19116-3854
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Country | US
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Telephone | 267-324-6388
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS038325
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License Number State | PA
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