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Individual

DR. MATTHEW JOHN THACKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
4 SUNSET WAY BLDG B, HENDERSON, NV 89014-2015
(702) 968-7076
Mailing address
12028 HATHAWAY PINES LN, LAS VEGAS, NV 89138-4501
(702) 408-7224

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7102
NV

Other

Enumeration date
07/11/2018
Last updated
11/30/2022
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