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General NPI Number Information
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NPI Number | 1659613131
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Entity Type | Individual
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Provider Name | MATTHEW K SONES DMD
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Gender | Male
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Dates
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Enumeration Date | 03/21/2013
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Last Update Date | 03/21/2013
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Provider Practice Location Address
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Address Line | 4303 13TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11219-1337
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Country | US
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Telephone | 718-871-9111
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Fax |
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Provider Business Mailing Address
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Address Line | 249 EMERSON DR
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City | LAFAYETTE HILL
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State | PA
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Zip | 19444-1347
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Country | US
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Telephone | 610-405-0749
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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 | 22DI02512200
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License Number State | NJ
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