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NPI Code Detail

MEDICARE: CHAD D MATONE D.D.S.

MEDICARE:   CHAD D MATONE  D.D.S.
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 Dentistry3574AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
23574OTHERARDELTA DENTAL
31876078OTHERARUNITED CONCORDIA
45Y906OTHERARAR BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1821149337
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHAD D MATONE D.D.S.
Provider Business Mailing Address
First Line : 7400 N HILLS BLVD
Second Line :
City : N LITTLE ROCK
State : AR
Zip : 72116-4539
Country : US
Telephone Number : 501-835-4567
Fax Number : 501-834-9178
Provider Business Practice Location Address
First Line : 7400 N HILLS BLVD
Second Line :
City : N LITTLE ROCK
State : AR
Zip : 72116-4539
Country : US
Telephone Number : 501-835-4567
Fax Number : 501-834-9178
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2007
Last Update Date : 12/27/2011

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Directions to “ CHAD D MATONE D.D.S.” Practice Location

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