Provider Demographics
NPI:1134217193
Name:MATTDMD,P.A.
Entity type:Organization
Organization Name:MATTDMD,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SCHLOSS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:609-586-6100
Mailing Address - Street 1:1700 WHITEHORSE HAMILTON SQUARE RD
Mailing Address - Street 2:SUITE D-3
Mailing Address - City:HAMILTON SQUARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3536
Mailing Address - Country:US
Mailing Address - Phone:609-586-6100
Mailing Address - Fax:609-584-0416
Practice Address - Street 1:1700 WHITEHORSE HAMILTON SQUARE RD
Practice Address - Street 2:SUITE D-3
Practice Address - City:HAMILTON SQUARE
Practice Address - State:NJ
Practice Address - Zip Code:08690-3536
Practice Address - Country:US
Practice Address - Phone:609-586-6100
Practice Address - Fax:609-584-0416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI194821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty