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NPI Code Detail

MEDICARE: DR. ALVIN CHARLES MATTHEWS DDS

MEDICARE: DR. ALVIN CHARLES MATTHEWS 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
1122300000XDentist4827AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1969365OTHERAZUNITED CONCORDIA

General Provider Information

NPI Number : 1336338102
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALVIN CHARLES MATTHEWS DDS
Provider Business Mailing Address
First Line : 7777 N 43RD AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85051-5712
Country : US
Telephone Number : 623-937-0267
Fax Number : 623-847-3737
Provider Business Practice Location Address
First Line : 7777 N 43RD AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85051-5712
Country : US
Telephone Number : 623-937-0267
Fax Number : 623-847-3737
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2007
Last Update Date : 10/17/2007

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