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Contact Information

MATT R AGNEW, DMD
1270 W MAIN ST
SUN PRAIRIE, WI53590-1930
 Phone: 608-443-5482
 Fax: 608-837-9134
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dental Public Health

1223D0001X
Indicates primary specialty

NPI Profile & details for MATT R AGNEW · (Male)

NPI # 1295916419
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 11/15/2007
Last updated 05/04/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 6179-15
  • WI Medicaid 33815700
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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