Provider Demographics
NPI:1558548198
Name:MELVIN LANDEW DDS, MATTHEW HORN DDS
Entity Type:Organization
Organization Name:MELVIN LANDEW DDS, MATTHEW HORN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:908-686-0409
Mailing Address - Street 1:440 CHESTNUT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-3100
Mailing Address - Country:US
Mailing Address - Phone:908-686-0409
Mailing Address - Fax:908-686-7967
Practice Address - Street 1:440 CHESTNUT ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3100
Practice Address - Country:US
Practice Address - Phone:908-686-0409
Practice Address - Fax:908-686-7967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5830-9354261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ310380OtherNJ RADATION REGISTRY