Provider Demographics
NPI:1891707824
Name:MATTHEWS, NEIL LENDON (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:LENDON
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1359 SIGNAL LANE
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48360
Mailing Address - Country:US
Mailing Address - Phone:248-620-0318
Mailing Address - Fax:
Practice Address - Street 1:543 MAIN STREET
Practice Address - Street 2:SUITE 412
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307
Practice Address - Country:US
Practice Address - Phone:248-656-0680
Practice Address - Fax:248-656-1321
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI148511223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics