Provider Demographics
NPI:1730222647
Name:SHEFFER, MATTHEW W (DDS)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:W
Last Name:SHEFFER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 248813
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73124-8813
Mailing Address - Country:US
Mailing Address - Phone:405-848-7974
Mailing Address - Fax:405-848-0033
Practice Address - Street 1:5227 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4938
Practice Address - Country:US
Practice Address - Phone:417-625-1122
Practice Address - Fax:417-625-1210
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK302204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery