Dr. Matthew Scott Detar
Endodontist
10682 Crestwood Dr Ste C
Manassas
, Virginia 20109-4401
Dr. Matthew Scott Detar
Endodontist
10682 Crestwood Dr Ste C
Manassas
, Virginia 20109-4401
(703) 368-8120
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About
Features
Specialties
- Endodontist
Languages spoken
- English
Location
First Address
- Dr. Matthew Scott Detar
- 10682 Crestwood Dr Ste C
- Manassas, VA
- Zip : 20109-4401
- Phone : (703) 368-8120
Second Address
- Dr. Matthew Scott Detar
- 10682 Crestwood Dr Ste C
- Manassas, VA
- Zip : 20109-4401
- Phone : (703) 368-8120
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223E0200X | Endodontist | 0401411877 | VA |
National Provider Identifier
| NPI | 1073770608 |
|---|---|
| Provider Name | Dr. Matthew Scott Detar |
| First Address | Manassas, VA 20109-4401 |
| Second Address | Manassas, VA 20109-4401 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/05/2008 |
| Last Update Date | 01/10/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.