Provider Demographics
NPI:1447632245
Name:STRANGE, MATTHEW (DMD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:STRANGE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9920 WADSWORTH PKWY
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-6847
Mailing Address - Country:US
Mailing Address - Phone:720-501-4782
Mailing Address - Fax:
Practice Address - Street 1:9920 WADSWORTH PKWY
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-6847
Practice Address - Country:US
Practice Address - Phone:720-501-4782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6216122300000X
CODEN.002028051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist