Individual
JOHN D MATHES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
603 N MAIN, PRATT, KS 67124
(620) 672-9922
Mailing address
603 N MAIN, PRATT, KS 67124
(620) 672-9922
(620) 672-9966
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5971
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000116868
BLUE CROSS BLUE SHIELD
KS
Enumeration date
02/08/2006
Last updated
07/08/2007
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