Provider Demographics
NPI:1205940384
Name:COATS, MATTHEW JONATHAN (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JONATHAN
Last Name:COATS
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-5525
Mailing Address - Country:US
Mailing Address - Phone:281-255-4746
Mailing Address - Fax:
Practice Address - Street 1:1017 W MAIN ST
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-5525
Practice Address - Country:US
Practice Address - Phone:281-255-4746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX159701223X0400X
CA604641223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics