Individual
DR. EVAN MATTHYSSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4419 FRONTIER TRL STE 104, AUSTIN, TX 78745-1567
(917) 817-0803
Mailing address
4419 FRONTIER TRL STE 104, AUSTIN, TX 78745-1567
(917) 817-0803
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
22DI02685300
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
36043
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/25/2016
Last updated
07/23/2024
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