Individual
DR. MATTHEW SCOTT DETAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10682 CRESTWOOD DR STE C, MANASSAS, VA 20109-4401
(703) 368-8120
Mailing address
10682 CRESTWOOD DR STE C, MANASSAS, VA 20109-4401
(703) 368-8120
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
0401411877
VA
Other
Enumeration date
05/21/2008
Last updated
10/01/2018
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