Mathewson, Kevin Todd

Mathewson, Kevin Todd is an individual health care provider with primary practice located at 415 South State Street , Big Rapids MI 49307-2049. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Mathewson, Kevin Todd can be contacted via phone (231) 796-3571.

Contact Information

Primary practice address
415 South State Street Big Rapids MI 49307-2049
Phone: (231) 796-3571
Fax: (231) 796-2211
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 29010-16945 Michigan

Profile Details

NPI number 1912072919
LBN Legal business name Mathewson, Kevin Todd
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2006
Last updated Jul 8th, 2007 - about 18 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 1912072919 NPPES
Michigan Other 3317643 MEDICAID
Michigan MEDICAID 3272864 MEDICAID
Michigan Other D169450 MEDICAID
Michigan Other 971753 MEDICAID

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