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NPI Code Detail

MEDICARE: DR. MATTHEW P LANE DDS

MEDICARE: DR. MATTHEW P LANE 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
1122300000XDentist41846CA

General Provider Information

NPI Number : 1578767547
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW P LANE DDS
Provider Business Mailing Address
First Line : 2506 PROFESSIONAL PKWY
Second Line :
City : SANTA MARIA
State : CA
Zip : 93455-1602
Country : US
Telephone Number : 805-938-0100
Fax Number :
Provider Business Practice Location Address
First Line : 2506 PROFESSIONAL PKWY
Second Line :
City : SANTA MARIA
State : CA
Zip : 93455-1602
Country : US
Telephone Number : 805-938-0100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 07/10/2007

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Directions to “ DR. MATTHEW P LANE DDS” Practice Location

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