Provider Demographics
NPI:1366435141
Name:CHESLER, MATTHEW BRIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:BRIAN
Last Name:CHESLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1757 GRAIN MILL RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-1062
Mailing Address - Country:US
Mailing Address - Phone:323-481-3740
Mailing Address - Fax:
Practice Address - Street 1:19871 MITSCHER WAY
Practice Address - Street 2:MCAS MIRAMAR
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92415
Practice Address - Country:US
Practice Address - Phone:760-577-7857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA525911223E0200X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice