Individual
CHRISTOPHER THOMAS MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4744 BRYANT IRVIN RD, FORT WORTH, TX 76132-3646
(817) 786-0837
Mailing address
8975 W WARM SPRINGS RD APT 2104, LAS VEGAS, NV 89148-2898
(910) 261-0643
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
36215
TX
1223G0001X
General Practice Dentistry
Primary
36215
TX
Other
Enumeration date
06/19/2020
Last updated
06/19/2020
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