Whitesides, Matthew David

Whitesides, Matthew David is an individual health care provider with primary practice located at 100 N 11Th Ave , Greeley CO 80631-2011. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is his primary health care specialty. Whitesides, Matthew David can be contacted via phone (970) 313-0353.

Contact Information

Primary practice address
100 N 11Th Ave Greeley CO 80631-2011
Phone: (970) 313-0353
Fax: (970) 351-7075
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 9976 Colorado
Dental Providers / Pediatric Dentistry 1223P0221X 9976 Colorado

Profile Details

NPI number 1366672875
LBN Legal business name Whitesides, Matthew David
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2009
Last updated Jun 30th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366672875 NPPES
Colorado MEDICAID 65000846

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