Individual
DR. MATTHEW THOMAS LETTRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1230 S MAIN ST, GRAPEVINE, TX 76051-5544
(817) 909-2920
Mailing address
1230 S MAIN ST, GRAPEVINE, TX 76051-5544
(865) 250-6919
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DEN.00203892
CO
1223P0221X
Pediatric Dentistry
Primary
37471
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2017
Last updated
01/17/2024
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