Provider Demographics
NPI:1659181279
Name:MATHEWSON, EMILY MARIE (DMD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:MATHEWSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 DARCZUK DR
Mailing Address - Street 2:
Mailing Address - City:GARNET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19060-1764
Mailing Address - Country:US
Mailing Address - Phone:610-235-9450
Mailing Address - Fax:
Practice Address - Street 1:5000 CHICHESTER AVE STE 1
Practice Address - Street 2:
Practice Address - City:UPPER CHICHESTER
Practice Address - State:PA
Practice Address - Zip Code:19014-2333
Practice Address - Country:US
Practice Address - Phone:610-485-1991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044903122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist