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General NPI Number Information
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NPI Number | 1861710931
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Entity Type | Organization
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Legal Business Name | MATTHEWS DENTAL ASSOCIATES, PA
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Dates
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Enumeration Date | 05/13/2010
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Last Update Date | 05/13/2010
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Provider Practice Location Address
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Address Line | 451 HOCKESSIN CORS
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City | HOCKESSIN
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State | DE
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Zip | 19707-9586
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Country | US
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Telephone | 302-234-2440
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Fax |
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Provider Business Mailing Address
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Address Line | 100 HAWTHORNE CT W
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City | HOCKESSIN
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State | DE
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Zip | 19707-1800
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Country | US
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Telephone | 302-234-4737
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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. DANIEL E MATTHEWS
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Credential | D.M.D.
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Telephone | 302-234-4737
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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 | G10000855
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | G10001247
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | G10001222
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License Number State | DE
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