Provider Demographics
NPI:1922356997
Name:ROWE, MATTHEW JOSEPH (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JOSEPH
Last Name:ROWE
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 N BELTLINE BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-4518
Mailing Address - Country:US
Mailing Address - Phone:803-782-0528
Mailing Address - Fax:803-782-1036
Practice Address - Street 1:2120 N BELTLINE BLVD
Practice Address - Street 2:STE B
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-4518
Practice Address - Country:US
Practice Address - Phone:803-782-0528
Practice Address - Fax:803-782-1036
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-24
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011462A1223P0300X
SC84891223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics