Provider Demographics
NPI:1518344100
Name:MATOS, JANIRIS RUTH (DMD)
Entity Type:Individual
Prefix:DR
First Name:JANIRIS
Middle Name:RUTH
Last Name:MATOS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 VINTON ST
Mailing Address - Street 2:DENTAL CLINIC
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3928
Mailing Address - Country:US
Mailing Address - Phone:603-627-8800
Mailing Address - Fax:
Practice Address - Street 1:8 VINTON STREET
Practice Address - Street 2:DENTAL CLINIC
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103
Practice Address - Country:US
Practice Address - Phone:603-627-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-03
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH042331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice