Organization
THOMAS S MATTEUCCI DDS LTD
Active
Other names
Matteucci Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW MATTEUCCI DMD (PRESIDENT)
(702) 365-6499
Entity
Organization
Contact information
Practice address
2764 LAKE SAHARA DR STE 107, LAS VEGAS, NV 89117-3400
(702) 365-6499
(702) 221-8465
Mailing address
2764 LAKE SAHARA DR STE 107, LAS VEGAS, NV 89117-3400
(702) 365-6499
(702) 221-8465
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972899391
—
NV
Enumeration date
01/25/2022
Last updated
01/25/2022
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