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General NPI Number Information
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NPI Number | 1831909779
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Entity Type | Organization
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Legal Business Name | MIDWEST DENTAL ANESTHESIA MATHEW D CAREW LLC
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 3443 MEDINA RD STE 105
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City | MEDINA
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State | OH
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Zip | 44256-5361
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Country | US
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Telephone | 216-387-7690
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Fax |
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Provider Business Mailing Address
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Address Line | 1291 S MEDINA LINE RD
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City | WADSWORTH
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State | OH
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Zip | 44281-9604
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Country | US
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Telephone | 216-387-7690
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. MATHEW DAVID CAREW
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Credential | DMD
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Telephone | 216-387-7690
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number |
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License Number State |
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