Provider Demographics
NPI:1295963726
Name:DOVER, MATTHEW W (DDS)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:W
Last Name:DOVER
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 1:108 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-2820
Mailing Address - Country:US
Mailing Address - Phone:501-843-7726
Mailing Address - Fax:501-843-3561
Practice Address - Street 1:108 S 10TH ST
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-2820
Practice Address - Country:US
Practice Address - Phone:501-843-7726
Practice Address - Fax:501-843-3561
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR37211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice