Provider Demographics
NPI:1669560546
Name:MATTHEW A POLLARD DDS PC
Entity type:Organization
Organization Name:MATTHEW A POLLARD DDS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:A
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-692-4490
Mailing Address - Street 1:3100 NW BUCKLIN HILL RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8358
Mailing Address - Country:US
Mailing Address - Phone:360-692-4490
Mailing Address - Fax:
Practice Address - Street 1:3100 NW BUCKLIN HILL RD
Practice Address - Street 2:SUITE 202
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8358
Practice Address - Country:US
Practice Address - Phone:360-692-4490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000102231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty