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Individual

R MATTHEW MINER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
11829
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0016777
NEIGHBORHOOD HEALTH PLAN
01
11829
DELTA DENTAL
01
16419
HARVARD PILGRIM POS
01
DMA502
FIRST SENIORITY
01
X05827
DENTAL BLUE
Enumeration date
06/28/2005
Last updated
07/13/2026
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