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Individual

DR. MATTHEW GREGORY BOOTHE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
3470 E MERIDIAN PARK LOOP, WASILLA, AK 99654-7294
(907) 373-8684
Mailing address
2924 E ODSATHER CIR, WASILLA, AK 99654-7294
(210) 710-9296

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
30627
TX
1223P0221X
Pediatric Dentistry
Primary
109471
AK

Other

Enumeration date
06/06/2014
Last updated
09/02/2016
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