Blake Lynn Matthews, DDS Valid NPI
Individual provider · General Practice Dentistry · Provo, UT
- NPI
- 1477693802
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 222754989922 (UT)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2007-02-07
- Last updated
- 2007-07-08
Practice location
3610 N University Ave, #200
Provo, UT 84604-4437
(801) 377-9600