Organization
STUART PEDIATRIC DENTISTRY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS A MATOS DMD (PRESIDENT)
(772) 600-5130
Entity
Organization
Contact information
Practice address
800 SE OCEAN BLVD, SUITE A, STUART, FL 34994-2448
(772) 600-5130
(772) 600-5523
Mailing address
800 SE OCEAN BLVD, SUITE A, STUART, FL 34994-2448
(772) 600-5130
(772) 600-5523
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223D0001X
Public Health Dentistry
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
126900000X
Dental Laboratory Technician
—
—
Other
Enumeration date
03/27/2012
Last updated
03/27/2012
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