Individual
DR. MATT GORDON VANDERMOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4701 WABASH AVE, SPRINGFIELD, IL 62711-9694
(217) 546-3333
Mailing address
4701 WABASH AVE, SPRINGFIELD, IL 62711-9694
(217) 546-3333
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
10/28/2006
Last updated
07/08/2007
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