Andrew S Matta Dmd Boardman Llc

NPI 1194029736 - Dentist - 1223G0001X

NPI Details
NPI 1194029736
Enumeration Date 12/22/2010
Last Updated 12/22/2010
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name ANDREW S ANDREW
Position SOLE OWNER
Phone (330) 758-6165
Fax (330) 533-2700
Practice Location
6540 SOUTH AVE
BOARDMAN OH, 44512-3651, US
Phone (330) 758-6165
Fax (330) 533-2700
Business Location
3800 BOARDMAN CANFIELD RD
CANFIELD OH, 44406-9029, US
Phone (330) 533-3400
Fax (330) 533-2700
Toxanomy
Taxonomy Code 1223G0001X
License State Pennsylvania
License Number DS036253
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According to our database, Andrew S Matta Dmd Boardman Llc NPI is 1194029736, taxonomy code is 1223G0001X and license number is DS036253, license state is located at Pennsylvania. Andrew S Matta Dmd Boardman Llc physically located at 6540 South Ave, Boardman OH, 44512-3651. NPI Number 1033115704 has the healthcare provider type.

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1194029736 NPI number is provided on an as is basis without warranty of any kind. 1194029736 is maintained by the National Plan & Provider Enumeration System. The contents of Andrew S Matta Dmd Boardman Llc are for informational purposes only.