Provider Demographics
NPI:1770503278
Name:KRESSIN, MATTHEW DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DAVID
Last Name:KRESSIN
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 1:526 LEGACY DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6750
Mailing Address - Country:US
Mailing Address - Phone:615-459-8055
Mailing Address - Fax:615-459-6023
Practice Address - Street 1:526 LEGACY DR
Practice Address - Street 2:SUITE 120
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-6750
Practice Address - Country:US
Practice Address - Phone:615-459-8055
Practice Address - Fax:615-459-6023
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN83641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice