Provider Demographics
NPI:1811285984
Name:MATTHEW P MCMASTERS
Entity type:Organization
Organization Name:MATTHEW P MCMASTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCMASTERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:931-424-7250
Mailing Address - Street 1:403 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:PULASKI
Mailing Address - State:TN
Mailing Address - Zip Code:38478-4315
Mailing Address - Country:US
Mailing Address - Phone:931-424-7250
Mailing Address - Fax:931-363-0149
Practice Address - Street 1:403 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:TN
Practice Address - Zip Code:38478-4315
Practice Address - Country:US
Practice Address - Phone:931-424-7250
Practice Address - Fax:931-363-0149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7865122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3207426Medicaid
TN4013164OtherBCBS