Provider Demographics
NPI:1003947185
Name:MATTHEW W. NAKFOOR, DDS, PC
Entity Type:Organization
Organization Name:MATTHEW W. NAKFOOR, DDS, PC
Other - Org Name:HURON VALLEY ENDODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:W
Authorized Official - Last Name:NAKFOOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-429-3850
Mailing Address - Street 1:203 W MICHIGAN AVE
Mailing Address - Street 2:#204
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1329
Mailing Address - Country:US
Mailing Address - Phone:734-429-3850
Mailing Address - Fax:734-429-0502
Practice Address - Street 1:203 W MICHIGAN AVE
Practice Address - Street 2:#204
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1329
Practice Address - Country:US
Practice Address - Phone:734-429-3850
Practice Address - Fax:734-429-0502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI183431223E0200X
MI187941223E0200X
OH30.0222601223E0200X
OH30.0222591223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty