Provider Demographics
NPI:1295833341
Name:DOW, MATTHEW A (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:A
Last Name:DOW
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 1:438 EAST BALTIMORE STREET
Mailing Address - Street 2:
Mailing Address - City:TANEYTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21787-2304
Mailing Address - Country:US
Mailing Address - Phone:410-756-4373
Mailing Address - Fax:410-751-1774
Practice Address - Street 1:438 EAST BALTIMORE STREET
Practice Address - Street 2:
Practice Address - City:TANEYTOWN
Practice Address - State:MD
Practice Address - Zip Code:21787-2304
Practice Address - Country:US
Practice Address - Phone:410-756-4373
Practice Address - Fax:410-751-1774
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD69431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD9771OtherBLUE CROSS MEDICAL ID #
MD2379OtherBLUE CROSS BLUE SHIEL
MD413983OtherMEDICAL ASSISTANCE
PA413983OtherPA BS UNITED CONCORDIA