Individual
JESSICA MATTERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
1516 JARRET PL, BRONX, NY 10461-2607
(718) 405-8194
Mailing address
4846 W FOSTER AVE, CHICAGO, IL 60630-1640
(480) 794-0302
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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