MEDICARE: DR. MATTHEW HALIM HELMY SR. 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	122300000X	Dentist	DS 028158 L	PA

General Provider Information

NPI Number	:	1669437133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW HALIM HELMY SR. DMD

Provider Business Mailing Address
First Line	:	744 CHANDLER AVE
Second Line	:
City	:	RADCLIFF
State	:	KY
Zip	:	40160-8755
Country	:	US
Telephone Number	:	502-624-7313
Fax Number	:	502-624-3430

Provider Business Practice Location Address
First Line	:	2724 BRAVE RIFLES REGIMENT ROAD
Second Line	:
City	:	FORT KNOX
State	:	KY
Zip	:	40121
Country	:	US
Telephone Number	:	502-624-7313
Fax Number	:	502-624-7313

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	07/08/2007

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