Provider Demographics
NPI:1689244188
Name:MATTHEW T STREELMAN DDS MD PLLC
Entity Type:Organization
Organization Name:MATTHEW T STREELMAN DDS MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:T
Authorized Official - Last Name:STREELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MD
Authorized Official - Phone:877-667-7669
Mailing Address - Street 1:3023 80TH AVE SE STE 200
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-6014
Mailing Address - Country:US
Mailing Address - Phone:877-667-7669
Mailing Address - Fax:405-848-0033
Practice Address - Street 1:3023 80TH AVE SE STE 200
Practice Address - Street 2:
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-6014
Practice Address - Country:US
Practice Address - Phone:877-667-7669
Practice Address - Fax:405-848-0033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty