# JESSICA MATTERN DDS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073125746
- **Authorized official:** JESSICA MATTERN DDS (OWNER)
- **Authorized official phone:** (480) 794-0302

## Contact information

- **Practice address:** 326 W BURLINGTON AVE, LA GRANGE, IL 60525-2363
- **Practice address phone:** (480) 794-0302
- **Mailing address:** 4126 N LAWLER AVE, CHICAGO, IL 60641-1742
- **Mailing address phone:** (480) 794-0302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 08/23/2020
- **Last updated:** 08/23/2020