Provider Demographics
NPI:1184971418
Name:EUSTERMAN, MATTHEW VINCENT (DDS)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:VINCENT
Last Name:EUSTERMAN
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 1:2748 WORTH RD STE 4
Mailing Address - Street 2:US DENTAL COMMAND
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78234-6033
Mailing Address - Country:US
Mailing Address - Phone:210-221-8241
Mailing Address - Fax:
Practice Address - Street 1:2748 WORTH RD STE 4
Practice Address - Street 2:US DENTAL COMMAND
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78234-6033
Practice Address - Country:US
Practice Address - Phone:210-221-8241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00201826122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist