Mclellan, Matthew

Mclellan, Matthew is an individual health care provider with primary practice located at 1100 S Ponce De Leon Blvd Ste 2 , St Augustine FL 32084-6013. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Mclellan, Matthew can be contacted via phone (904) 829-6321.

Contact Information

Primary practice address
1100 S Ponce De Leon Blvd Ste 2 St Augustine FL 32084-6013
Phone: (904) 829-6321
Fax: (904) 829-2338
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DN11125 Florida

Profile Details

NPI number 1568495919
LBN Legal business name Mclellan, Matthew
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2006
Last updated Jul 8th, 2007 - about 17 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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