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NPI Code Detail

MEDICARE: MATTHEW W. DEVANEY, D.D.S. & ASSOCIATES PLLC

MEDICARE: MATTHEW W. DEVANEY, D.D.S. & ASSOCIATES PLLC
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 DentistryNC6974NC
21223G0001XGeneral Practice DentistryNC8237NC

General Provider Information

NPI Number : 1689824229
Entity Type Code : Organization
Provider Name (Legal Business Name) : MATTHEW W. DEVANEY, D.D.S. & ASSOCIATES PLLC
Provider Business Mailing Address
First Line : 6161 LAKE BRANDT RD UNIT A
Second Line :
City : GREENSBORO
State : NC
Zip : 27455-8415
Country : US
Telephone Number : 336-643-1440
Fax Number : 336-643-1065
Provider Business Practice Location Address
First Line : 6161 LAKE BRANDT RD UNIT A
Second Line :
City : GREENSBORO
State : NC
Zip : 27455-8415
Country : US
Telephone Number : 336-643-1440
Fax Number : 336-643-1065
Authorized Official
Title or Position : PARTNER
Name : MATTHEW W DEVANEY
Credential : DDS
Telephone Number : 336-643-1440
Provider Enumeration Date : 09/19/2008
Last Update Date : 03/31/2009

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