| Andrew S Matta Dmd Boardman Llc | |
|
6540 South Ave Boardman OH 44512-3651 | |
| (330) 758-6165 | |
| (330) 533-2700 |
| Full Name | Andrew S Matta Dmd Boardman Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6540 South Ave, Boardman, Ohio |
| Authorized Official Name and Position | Andrew S Matta (SOLE OWNER) |
| Authorized Official Contact | 3305333400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Andrew S Matta Dmd Boardman Llc 3800 Boardman Canfield Rd Canfield OH 44406-9029 Ph: (330) 533-3400 | Andrew S Matta Dmd Boardman Llc 6540 South Ave Boardman OH 44512-3651 Ph: (330) 758-6165 |
| NPI Number | 1194029736 |
|---|---|
| Provider Enumeration Date | 12/22/2010 |
| Last Update Date | 12/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194029736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | DS036253 (Pennsylvania) | Primary |
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