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Contact Information

MATTHEW S DETAR, DDS
10682 CRESTWOOD DR STE C
MANASSAS, VA20109-4401
 Phone: 703-368-8120
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for MATTHEW S DETAR · (Male)

NPI Number 1073770608
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 05/21/2008
Last updated 10/01/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • VA License # 0401411877
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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