Provider Demographics
NPI:1023102894
Name:ECKERT, MATTHEW F (DDS)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:F
Last Name:ECKERT
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 1:429 N JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:46750-2746
Mailing Address - Country:US
Mailing Address - Phone:260-356-6651
Mailing Address - Fax:260-356-7751
Practice Address - Street 1:429 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750-2746
Practice Address - Country:US
Practice Address - Phone:260-356-6651
Practice Address - Fax:260-356-7751
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009559A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice