Provider Demographics
NPI:1881996676
Name:MOY, MATTHEW GENE (DDS)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:GENE
Last Name:MOY
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 1:12900 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-3742
Mailing Address - Country:US
Mailing Address - Phone:301-949-5400
Mailing Address - Fax:301-949-4320
Practice Address - Street 1:12900 GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-3742
Practice Address - Country:US
Practice Address - Phone:301-949-5400
Practice Address - Fax:301-949-4320
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD133751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice