Provider Demographics
NPI:1548878077
Name:DOUGLAS M. MATTHEWS,D.D.S.,P.A.
Entity type:Organization
Organization Name:DOUGLAS M. MATTHEWS,D.D.S.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-793-7610
Mailing Address - Street 1:350 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-5624
Mailing Address - Country:US
Mailing Address - Phone:870-793-7610
Mailing Address - Fax:870-793-9046
Practice Address - Street 1:350 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-5624
Practice Address - Country:US
Practice Address - Phone:870-793-7610
Practice Address - Fax:870-793-9046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental