Individual
DR. THOMAS RICHARD MATTESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6800 MONTGOMERY BLVD NE, SUITE-C, ALBUQUERQUE, NM 87109-1405
(505) 884-8000
Mailing address
6800 MONTGOMERY BLVD NE, SUITE-C, ALBUQUERQUE, NM 87109-1405
(505) 884-8000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001
NM
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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