# MATTHEW HEARN LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Matthew Hearn Ltd
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265216881
- **Authorized official:** DR. MATTHEW WILLIAM HEARN DDS, MD (ORAL SURGEON)
- **Authorized official phone:** (504) 220-7344

## Contact information

- **Practice address:** 3204 LANCER ST STE B, PORTAGE, IN 46368-4491
- **Practice address phone:** (219) 762-1806
- **Practice address fax:** (219) 763-9979
- **Mailing address:** 3712 LAKE HURON DR APT 104, VALPARAISO, IN 46383-6746
- **Mailing address phone:** (504) 220-7344

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 08/23/2023
- **Last updated:** 08/23/2023