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NPI Code Detail

MEDICARE: DR. MATTHEW PATRICK MCMASTERS DDS

MEDICARE: DR. MATTHEW PATRICK MCMASTERS 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
11223G0001XGeneral Practice DentistryDO7865TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
116030OTHERTNDORAL
24013164OTHERTNBCBS

General Provider Information

NPI Number : 1578545703
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW PATRICK MCMASTERS DDS
Provider Business Mailing Address
First Line : 403 E COLLEGE ST
Second Line :
City : PULASKI
State : TN
Zip : 38478-4315
Country : US
Telephone Number : 931-424-7250
Fax Number : 931-363-0149
Provider Business Practice Location Address
First Line : 403 E COLLEGE ST
Second Line :
City : PULASKI
State : TN
Zip : 38478-4315
Country : US
Telephone Number : 931-424-7250
Fax Number : 931-363-0149
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 07/08/2007

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