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General NPI Number Information
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NPI Number | 1760257844
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Entity Type | Organization
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Legal Business Name | DR MATTHEW KING DDS INC
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 27521 JEFFERSON AVE
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City | TEMECULA
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State | CA
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Zip | 92590-2600
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Country | US
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Telephone | 951-676-3676
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Fax |
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Provider Business Mailing Address
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Address Line | 29432 WYATT EARP WAY
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City | WINCHESTER
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State | CA
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Zip | 92596-7608
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Country | US
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Telephone | 360-567-5978
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MATTHEW MICHAEL KING
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Credential | DDS
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Telephone | 360-567-5978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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