Individual
JOSEPH D MATTHEWS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2415 W PARK PLACE BLVD, STONE MOUNTAIN, GA 30087-3566
(470) 986-1004
Mailing address
2415 W PARK PLACE BLVD, STONE MOUNTAIN, GA 30087-3566
(470) 986-1004
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DD1673
NM
1223X2210X
Orofacial Pain Dentistry
D008997
AZ
1223X2210X
Orofacial Pain Dentistry
Primary
DN123016
GA
Other
Enumeration date
07/07/2005
Last updated
01/23/2024
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