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General NPI Number Information
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NPI Number | 1427467802
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Entity Type | Individual
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Provider Name | MATTHEW JONATHAN SIEGEL DDS
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Gender | Male
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 2592 MERRICK RD SUITE C
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City | BELLMORE
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State | NY
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Zip | 11710-5742
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Country | US
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Telephone | 516-781-9700
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Fax | 516-781-1936
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Provider Business Mailing Address
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Address Line | 2592 MERRICK RD SUITE C
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City | BELLMORE
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State | NY
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Zip | 11710-5742
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Country | US
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Telephone | 516-781-9700
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Fax | 516-781-1936
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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 | 50 057441
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License Number State | NY
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