Provider Demographics
NPI:1790848935
Name:CATER, MATHEW I (DMD)
Entity Type:Individual
Prefix:DR
First Name:MATHEW
Middle Name:I
Last Name:CATER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:894 E ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4746
Mailing Address - Country:US
Mailing Address - Phone:630-932-0090
Mailing Address - Fax:630-932-0156
Practice Address - Street 1:894 E ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4746
Practice Address - Country:US
Practice Address - Phone:630-932-0090
Practice Address - Fax:630-932-0156
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice