Provider Demographics
NPI:1841547932
Name:MATIN, BRITANY FABIAN (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:BRITANY
Middle Name:FABIAN
Last Name:MATIN
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 N COLLEGE ST STE D
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-3030
Mailing Address - Country:US
Mailing Address - Phone:334-444-0571
Mailing Address - Fax:
Practice Address - Street 1:670 N COLLEGE ST STE D
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-3030
Practice Address - Country:US
Practice Address - Phone:334-444-0571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5961 C1122300000X
AL59611223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist