Individual
DR. WAYNE A MATTERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1714 N 9TH ST, BISMARCK, ND 58501
(701) 223-1474
(701) 224-0038
Mailing address
1714 N 9TH ST, BISMARCK, ND 58501
(701) 223-1474
(701) 224-0038
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
ND1454
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40411
—
ND
Enumeration date
12/26/2006
Last updated
07/08/2007
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