Provider Demographics
NPI:1699860064
Name:LAWYER, MATT MCKENZIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATT
Middle Name:MCKENZIE
Last Name:LAWYER
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 1:9040 CAROTHERS PARKWAY
Mailing Address - Street 2:SUITE A203
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067
Mailing Address - Country:US
Mailing Address - Phone:615-771-7123
Mailing Address - Fax:615-771-9674
Practice Address - Street 1:9040 CAROTHERS PARKWAY
Practice Address - Street 2:SUITE A203
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067
Practice Address - Country:US
Practice Address - Phone:615-771-7123
Practice Address - Fax:615-771-9674
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN78191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice