Organization
THE PRACTICE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW KASIAR DMD (OWNER)
(618) 841-0971
Entity
Organization
Contact information
Practice address
1738 FONTANELLA DR, BRENTWOOD, TN 37027-2502
(618) 841-0971
Mailing address
1738 FONTANELLA DR, BRENTWOOD, TN 37027-2502
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/17/2021
Last updated
01/17/2021
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