Provider Demographics
NPI:1578545703
Name:MCMASTERS, MATTHEW PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:PATRICK
Last Name:MCMASTERS
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 1:403 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-4315
Mailing Address - Country:US
Mailing Address - Phone:931-424-7250
Mailing Address - Fax:931-363-0149
Practice Address - Street 1:403 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-4315
Practice Address - Country:US
Practice Address - Phone:931-424-7250
Practice Address - Fax:931-363-0149
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO78651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN16030OtherDORAL
TN4013164OtherBCBS