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General NPI Number Information
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NPI Number | 1831363480
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Entity Type | Organization
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Legal Business Name | DR MATTHEW SLATTERY DDS
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 802 OLD OYSTER POINT ROAD
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City | NEWPORT NEWS
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State | VA
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Zip | 23602
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Country | US
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Telephone | 757-595-2510
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Fax | 757-596-7187
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Provider Business Mailing Address
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Address Line | 802 OLD OYSTER POINT ROAD
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City | NEWPORT NEWS
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State | VA
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Zip | 23602
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Country | US
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Telephone | 757-595-2510
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Fax | 757-596-7187
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW DAVID SLATTERY
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Credential | DDS PLLC
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Telephone | 757-595-2510
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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 | 0401008887
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License Number State | VA
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