Provider Demographics
NPI:1639457369
Name:STARLEY, MATT (DMD)
Entity type:Individual
Prefix:DR
First Name:MATT
Middle Name:
Last Name:STARLEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 15TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-3813
Mailing Address - Country:US
Mailing Address - Phone:503-325-6662
Mailing Address - Fax:503-325-0637
Practice Address - Street 1:3617 S PACIFIC HWY
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-8957
Practice Address - Country:US
Practice Address - Phone:541-535-6239
Practice Address - Fax:541-512-1026
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD9638122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist