Provider Demographics
NPI:1942534219
Name:VICTORIA L. MATTHEWS, D.D.S., P.A.
Entity Type:Organization
Organization Name:VICTORIA L. MATTHEWS, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:207-338-6351
Mailing Address - Street 1:PO BOX 996
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-0996
Mailing Address - Country:US
Mailing Address - Phone:207-338-6351
Mailing Address - Fax:
Practice Address - Street 1:33 GRIFFIN ST
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:ME
Practice Address - Zip Code:04849-4445
Practice Address - Country:US
Practice Address - Phone:207-338-6351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-19
Last Update Date:2009-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME36061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty