Provider Demographics
NPI:1134566326
Name:DAILEY, MATTHEW (DDS, MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:DAILEY
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 S PATTERSON AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-2400
Mailing Address - Country:US
Mailing Address - Phone:058-682-8462
Mailing Address - Fax:
Practice Address - Street 1:334 S PATTERSON AVE STE 205
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2400
Practice Address - Country:US
Practice Address - Phone:805-682-8462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-28
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62941122300000X
CAA1911241223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
No122300000XDental ProvidersDentist