MEDICARE: DR. MATHEW DORSCH 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
1	1223G0001X	General Practice Dentistry	DE8193	WA

General Provider Information

NPI Number	:	1891841193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATHEW DORSCH DDS

Provider Business Mailing Address
First Line	:	3400 SQUALICUM PKWY
Second Line	:	SUITE 107
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-1933
Country	:	US
Telephone Number	:	360-734-9926
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 SQUALICUM PKWY
Second Line	:	SUITE 107
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-1933
Country	:	US
Telephone Number	:	360-734-9926
Fax Number	:

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

Provider Enumeration Date	:	01/27/2007
Last Update Date	:	10/14/2008

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