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General NPI Number Information
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NPI Number | 1275610743
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Entity Type | Individual
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Provider Name | MATTHEW L PINGEL D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 1967 NEWARK GRANVILLE RD
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City | GRANVILLE
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State | OH
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Zip | 43023-9172
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Country | US
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Telephone | 740-587-7000
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Fax | 740-587-7004
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Provider Business Mailing Address
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Address Line | 1967 NEWARK GRANVILLE RD
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City | GRANVILLE
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State | OH
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Zip | 43023-9172
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Country | US
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Telephone | 740-587-7000
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 30.021882
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License Number State | OH
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