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General NPI Number Information
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NPI Number | 1962399949
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Entity Type | Individual
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Provider Name | LANDON MATTHEWS DMD
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Gender | Female
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Dates
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Enumeration Date | 06/21/2025
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Last Update Date | 06/21/2025
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Provider Practice Location Address
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Address Line | 319 S MAIN ST
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City | BOUNTIFUL
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State | UT
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Zip | 84010-6237
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Country | US
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Telephone | 801-295-7171
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Fax |
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Provider Business Mailing Address
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Address Line | 172 E BRIDGEPARK CIR
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City | DRAPER
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State | UT
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Zip | 84020-8609
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 14228573-9926
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License Number State | UT
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