Provider Demographics
NPI:1962961094
Name:HURD, MATTHEW (PHD, DDS)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:HURD
Suffix:
Gender:M
Credentials:PHD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 FOLSOM ST APT 1702
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94105-3373
Mailing Address - Country:US
Mailing Address - Phone:310-868-4488
Mailing Address - Fax:
Practice Address - Street 1:450 FOLSOM ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-3172
Practice Address - Country:US
Practice Address - Phone:310-868-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-18
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1042171223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology