MEDICARE: DR. MARTY J MATZ DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	5582	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013976661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTY J MATZ DDS

Provider Business Mailing Address
First Line	:	15751 W DODGE RD
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68118-2536
Country	:	US
Telephone Number	:	402-397-8050
Fax Number	:	402-397-3566

Provider Business Practice Location Address
First Line	:	15751 W DODGE RD
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68118-2536
Country	:	US
Telephone Number	:	402-397-8050
Fax Number	:	402-397-3566

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	12/14/2015

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