Provider Demographics
NPI:1831278118
Name:GIRARDY, MATTHEW J (DMD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:GIRARDY
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 1:1285 BRADFORD RUN
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762
Mailing Address - Country:US
Mailing Address - Phone:732-449-3072
Mailing Address - Fax:
Practice Address - Street 1:2224 ROUTE 37 E
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-6000
Practice Address - Country:US
Practice Address - Phone:732-270-5566
Practice Address - Fax:732-270-2781
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ200091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice