Organization Name: | MATTHEW T. MULCAHY, D.M.D. |
NPI Number: | 1578749750 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MATTHEW TERRENCE MULCAHY (DENTIST) |
Mailing Address: | 9 Amelia Dr Nantucket |
State: | MA US |
Postal Code: | 025546063 |
Phone Number: | 5082284500 |
Fax Number: | 5082284585 |
NPI Enumeration Date: | 01/17/2008 |
NPI Last Update Date: | 06/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 21793 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |