Provider Demographics
NPI:1972948362
Name:BICKEL, MATTHEW F (DMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:F
Last Name:BICKEL
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 1:188 FRIES MILL RD
Mailing Address - Street 2:SUITE E-2
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-2015
Mailing Address - Country:US
Mailing Address - Phone:856-875-8400
Mailing Address - Fax:856-875-5329
Practice Address - Street 1:188 FRIES MILL RD
Practice Address - Street 2:SUITE E-2
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-2015
Practice Address - Country:US
Practice Address - Phone:856-875-8400
Practice Address - Fax:856-875-5329
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI18611122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist