Provider Demographics
NPI:1013054188
Name:ROWAN, MATTHEW BART (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:BART
Last Name:ROWAN
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 1:3351 NORTH M ST.
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348
Mailing Address - Country:US
Mailing Address - Phone:209-723-5454
Mailing Address - Fax:209-723-1952
Practice Address - Street 1:3351 NORTH M ST.
Practice Address - Street 2:SUITE 210
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-2731
Practice Address - Country:US
Practice Address - Phone:209-723-5454
Practice Address - Fax:209-723-1952
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA403911223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics