Provider Demographics
NPI:1891859427
Name:MATTHEWS, SUSAN SNOW (DMD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:SNOW
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 334
Mailing Address - Street 2:168 BLUFFTON ROAD
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-0334
Mailing Address - Country:US
Mailing Address - Phone:843-757-2828
Mailing Address - Fax:843-757-3319
Practice Address - Street 1:168 BLUFFTON ROAD
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-0334
Practice Address - Country:US
Practice Address - Phone:843-757-2828
Practice Address - Fax:843-757-3319
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice