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Individual

MATTHEW MATTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1 SAGEBRUSH ST SW, ALBUQUERQUE, NM 87105-3942
(505) 925-4031
(505) 925-4030
Mailing address
PO BOX 640, ISLETA, NM 87022-0640
(505) 925-4031
(505) 925-4030

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD4201
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DD4201
LICENSE
NM
Enumeration date
04/16/2013
Last updated
12/06/2016
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