Provider Demographics
NPI:1982662490
Name:CHEUNG, MATTHEW CLARENCE (DDS)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:CLARENCE
Last Name:CHEUNG
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 1:10946 E RAMONA BLVD
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2633
Mailing Address - Country:US
Mailing Address - Phone:626-444-2913
Mailing Address - Fax:626-452-1375
Practice Address - Street 1:10946 E RAMONA BLVD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2633
Practice Address - Country:US
Practice Address - Phone:626-444-2913
Practice Address - Fax:626-452-1375
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA272541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice