Individual
JONATHAN C MATTHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2841 NEAL METCALF RD, ENTERPRISE, AL 36330-6331
(334) 347-5551
(334) 347-5551
Mailing address
230 EAST 10TH STREET, SUITE 106, ANNISTON, AL 36207-5771
(256) 741-7340
(256) 741-7373
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5315
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51520606
BCBS
AL
05
—
630907079
—
AL
Enumeration date
07/25/2006
Last updated
09/17/2016
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