Provider Demographics
NPI:1598986051
Name:KEYSER, MATTHEW C (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:C
Last Name:KEYSER
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 1:115 SANSOME ST
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-3601
Mailing Address - Country:US
Mailing Address - Phone:415-781-9600
Mailing Address - Fax:415-362-1909
Practice Address - Street 1:115 SANSOME ST
Practice Address - Street 2:SUITE 1000
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-3601
Practice Address - Country:US
Practice Address - Phone:415-781-9600
Practice Address - Fax:415-362-1909
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA466201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice