MEDICARE: DR. MATTHEW K SONES DMD

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	1223P0221X	Pediatric Dentistry	22DI02512200	NJ

General Provider Information

NPI Number	:	1659613131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW K SONES DMD

Provider Business Mailing Address
First Line	:	249 EMERSON DR
Second Line	:
City	:	LAFAYETTE HILL
State	:	PA
Zip	:	19444-1347
Country	:	US
Telephone Number	:	610-405-0749
Fax Number	:

Provider Business Practice Location Address
First Line	:	4303 13TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-1337
Country	:	US
Telephone Number	:	718-871-9111
Fax Number	:

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

Provider Enumeration Date	:	03/21/2013
Last Update Date	:	03/21/2013

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