Provider Demographics
NPI:1225199342
Name:MATTHEWS, STEPHEN MCKOWN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MCKOWN
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SELMA AVE
Mailing Address - Street 2:
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-4166
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 HEALTH WAY DR
Practice Address - Street 2:SUITE 1
Practice Address - City:POTOSI
Practice Address - State:MO
Practice Address - Zip Code:63664-1434
Practice Address - Country:US
Practice Address - Phone:573-436-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0147351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice