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General NPI Number Information
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NPI Number | 1285082826
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Entity Type | Individual
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Provider Name | MATTHEW PERRY BYRNE DDS
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Gender | Male
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 2460 WILLAMETTE STREET LANE COMMUNITY COLLEGE DENTAL CL UPPER LEVEL
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City | EUGENE
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State | OR
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Zip | 97405
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Country | US
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Telephone | 541-463-5206
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Fax | 405-515-8170
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Provider Business Mailing Address
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Address Line | LCC DENTAL CLINIC 2460 WILLAMETTE STREET, UPPER LEVEL
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City | EUGENE
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State | OR
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Zip | 97405
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Country | US
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Telephone | 541-463-5206
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Fax | 405-515-8170
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 6817
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D11513
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License Number State | OR
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