Organization
MATTINGLY BOXDORFER DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN MARK MATTINGLY DDS (OWNER/DENTIST)
(573) 547-6691
Entity
Organization
Contact information
Practice address
22 S WEST ST, PERRYVILLE, MO 63775-2547
(573) 547-6691
(573) 547-6696
Mailing address
22 S WEST ST, PERRYVILLE, MO 63775-2547
(573) 547-6691
(573) 547-6696
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/29/2022
Last updated
07/05/2022
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