Provider Demographics
NPI:1124257076
Name:MATHEWS, DANIEL WRIGHT JR (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:WRIGHT
Last Name:MATHEWS
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4130 CARMICHAEL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3727
Mailing Address - Country:US
Mailing Address - Phone:334-277-8900
Mailing Address - Fax:334-819-8698
Practice Address - Street 1:4130 CARMICHAEL RD
Practice Address - Street 2:SUITE B
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3727
Practice Address - Country:US
Practice Address - Phone:334-277-8900
Practice Address - Fax:334-819-8698
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL56901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice