Provider Demographics
NPI:1790908580
Name:YERKEY, MATTHEW R (DDS)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:R
Last Name:YERKEY
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 1:2940 STATE ROUTE 45 S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-9465
Mailing Address - Country:US
Mailing Address - Phone:330-332-5377
Mailing Address - Fax:330-332-2754
Practice Address - Street 1:2940 STATE ROUTE 45 S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-9465
Practice Address - Country:US
Practice Address - Phone:330-332-5377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0190101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice