Organization
CHAD D MATONE DDS PA
Active
Other names
Malvern Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD D MATONE D.D.S (OWNER)
(901) 490-1293
Entity
Organization
Contact information
Practice address
230 PINE BLUFF ST, MALVERN, AR 72104-4228
(501) 337-4908
(501) 337-9929
Mailing address
230 PINE BLUFF ST, MALVERN, AR 72104-4228
(501) 337-4908
(501) 337-9929
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3574
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164408608
—
AR
01
—
5Y893
ARKANSAS BLUE CROSS BLUE SHEILD
AR
Enumeration date
01/10/2013
Last updated
02/15/2019
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