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General NPI Number Information
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NPI Number | 1962923359
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Entity Type | Organization
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Legal Business Name | ROBERT D MATTHEWS, DMD, PLLC
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 07/06/2017
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Provider Practice Location Address
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Address Line | 25225 N LAKE PLEASANT PKWY STE 1235
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City | PEORIA
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State | AZ
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Zip | 85383-1390
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Country | US
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Telephone | 623-243-5333
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Fax |
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Provider Business Mailing Address
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Address Line | 1722 W ASTER DR
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City | PHOENIX
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State | AZ
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Zip | 85029-2833
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Country | US
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Telephone | 602-291-2482
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT DEAN MATTHEWS
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Credential | DMD
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Telephone | 623-243-5333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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