Provider Demographics
NPI:1902290885
Name:MATTHEW ALDRED, D.D.S., P.C.
Entity Type:Organization
Organization Name:MATTHEW ALDRED, D.D.S., P.C.
Other - Org Name:ALDRED FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:HURRELL
Authorized Official - Last Name:ALDRED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:434-466-9563
Mailing Address - Street 1:17084 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VA
Mailing Address - Zip Code:23192-2565
Mailing Address - Country:US
Mailing Address - Phone:804-883-6070
Mailing Address - Fax:804-883-6070
Practice Address - Street 1:17084 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VA
Practice Address - Zip Code:23192-2565
Practice Address - Country:US
Practice Address - Phone:804-883-6070
Practice Address - Fax:804-883-6070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413284261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental