Michael David Mattiacio D.D.S.

NPI 1073631156 - Dentist - 1223G0001X

NPI Details
NPI 1073631156
Gender Male
Enumeration Date 03/27/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
2946 ERIE BLVD E
SYRACUSE NY, 13224-1431, US
Phone (315) 445-2678
Fax (315) 445-2838
Business Location
2946 ERIE BLVD E
SYRACUSE NY, 13224-1431, US
Phone (315) 445-2678
Fax (315) 445-2838
Toxanomy
Taxonomy Code 1223G0001X
License State New York
License Number 049454-1
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According to our database, Dr. Michael David Mattiacio D.D.S. NPI is 1073631156, taxonomy code is 1223G0001X and license number is 049454-1, license state is located at New York. Michael David Mattiacio D.D.S. physically located at 2946 Erie Blvd E, Syracuse NY, 13224-1431. NPI Number Michael David Mattiacio D.D.S. has the Individual type.

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1073631156 NPI number is provided on an as is basis without warranty of any kind. 1073631156 is maintained by the National Plan & Provider Enumeration System. The contents of Michael David Mattiacio D.D.S. are for informational purposes only.