Individual
JESSICA MATTERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019.030577
IL
Other
Enumeration date
03/10/2015
Last updated
07/25/2016
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