Provider Demographics
NPI:1609086479
Name:MATTHEWS, MARY KATHERINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARY KATHERINE
Middle Name:
Last Name:MATTHEWS
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 1:451 HOCKESSIN CORS
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-9586
Mailing Address - Country:US
Mailing Address - Phone:302-234-2440
Mailing Address - Fax:302-234-2444
Practice Address - Street 1:451 HOCKESSIN CORS
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-9586
Practice Address - Country:US
Practice Address - Phone:302-234-2440
Practice Address - Fax:302-234-2444
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0371891223P0221X
DEPENDING1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry