Provider Demographics
NPI:1902983414
Name:MATTHEWS, DANIEL E (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:E
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 SILVERSIDE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4434
Mailing Address - Country:US
Mailing Address - Phone:302-475-9220
Mailing Address - Fax:302-475-9210
Practice Address - Street 1:1403 SILVERSIDE RD
Practice Address - Street 2:SUITE A
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4434
Practice Address - Country:US
Practice Address - Phone:302-475-9220
Practice Address - Fax:302-475-9210
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00012221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000040560Medicaid