Provider Demographics
NPI:1245420827
Name:GARRETT, MATTHEW JON (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JON
Last Name:GARRETT
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 1:15009 W BELL RD
Mailing Address - Street 2:BUILDING 10, STE 175
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-3213
Mailing Address - Country:US
Mailing Address - Phone:623-476-8100
Mailing Address - Fax:623-792-5311
Practice Address - Street 1:15009 W BELL RD
Practice Address - Street 2:BUILDING 10, STE 175
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3213
Practice Address - Country:US
Practice Address - Phone:623-476-8100
Practice Address - Fax:623-792-5311
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ72761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice