Provider Demographics
NPI:1548319213
Name:COMFORT, MATTHEW ROBERT (DDS, INC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ROBERT
Last Name:COMFORT
Suffix:
Gender:M
Credentials:DDS, INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:568 N SUNRISE AVE STE 390
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3097
Mailing Address - Country:US
Mailing Address - Phone:916-786-2010
Mailing Address - Fax:916-786-0440
Practice Address - Street 1:568 N SUNRISE AVE STE 390
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3097
Practice Address - Country:US
Practice Address - Phone:916-786-2010
Practice Address - Fax:916-786-0440
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA446631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice