Individual
DR. TODD L MATHESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3315 S HOLMES AVE, IDAHO FALLS, ID 83404-7981
(208) 522-4491
Mailing address
3315 S HOLMES AVE, IDAHO FALLS, ID 83404-7981
(208) 522-4491
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D-5574
ID
1223G0001X
General Practice Dentistry
10729
CO
Other
Enumeration date
07/07/2011
Last updated
11/20/2024
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